Claim CLM-2024-8819
Patient
- Name
- Bruno Ferreira
- Date of birth
- 1959-11-03
- Patient id
- H003
Payer
- Name
- BCBS
- Payer id code
- 00210
Provider
- Name
- Northside Medical
- NPI
- 1982744321
Service
- Date of service
- Apr 15 (denial date, no service date on file)
- Procedure
- 27447, Hip Arthroplasty
- Diagnosis code
- M17.11
- Billed amount
- $29,100
Denial
- Reason
- Bundling/Coding Error, code 97
- Date
- Apr 15
Appeal
- Status
- No appeal filed yet
Prepared by Heron on Aug 30.