Renelique v American Tr. Ins. Co., 2016 NY Slip Op 51526(U)(App. Term 2d Dept. 2016)
“[d]efendant also submitted an affidavit executed by its no-fault examiner, who described how the fees for the services at issue had been calculated by multiplying the appropriate “relative value” by the appropriate “conversion factor.” Plaintiff’s remaining argument with respect to the coding expert’s affidavit and the specific argument made by plaintiff with regard to CPT code 99244 were not raised in the Civil Court, and are therefore not properly before this court.
With respect to plaintiff’s final argument, which involves CPT code 20553, we find that defendant made a prima facie showing that it had used the assigned relative value for that code to calculate the sum to which plaintiff was entitled to be reimbursed.”
The Court held that an affidavit of a claims representative who averred that a “relative value” multiplied by the “conversion factor” is sufficient to prove the compensable amount.
