Up Code

I have been a medical biller for 24 years. When I receive an explanation of benefits from my own doctors, I tend to make sure the code is correct. I received an EOB the other day for when my husband needed medical clearance for a cataract surgery. The doctor billed the insurance company $500 and coded it as a consultation. I did not have to pay a copay, but I was annoyed that the doctor's office billed that way. I called to question it. They got a bit nasty and said it was correct. I had the coding book in front of me and I said it was not correct. He did not receive that high of a level of services. They used the code for a new patient or a patient who had not been seen by the doctor in over a year and needed a comprehensive exam. He sees the doctor every 6 months. All they did was do an EKG, which was charged for separately, and take his blood pressure. They will not change the code and resubmit, but at least they now know not to do that to me again.