Appeals / #4471

To the Billing & Appeals Department,

I am writing to formally dispute charges on the itemized statement referenced above. On review, the statement contains billing errors that I am asking you to correct before I remit payment.

First, CPT 80053 (comprehensive metabolic panel) appears twice for the same date of service; per your own itemization, only one specimen was collected. I request removal of the duplicate charge of $214.00.

Second, the encounter was billed at CPT 99285 (Level 5); the documented complexity supports CPT 99283 (Level 3). I dispute the difference between the two levels.

Please confirm the corrected balance in writing. I have retained a copy of this appeal and the itemized statement it cites.