Radiology Coding Alert
Avoid 'S' Codes When Billing Medicare
Question: I read your March article "No Code? No Problem" regarding unlisted-procedure codes, and I am wondering whether you also recommend assigning the HCPCS Codes S8037 and S2250 for unlisted procedures.
Answer: If you are billing Medicare, you should not report S8037 (Magnetic resonance cholangiopancreatography) or S2250 (Uterine artery embolization for uterine fibroids). According to the HCPCS Manual, "The S codes are used by the Blue Cross/Blue Shield Association (BCBSA) and the Health Insurance Association of America (HIAA) to report drugs, services and supplies for which there are no national codes but for which codes are needed by the private sector to implement policies, programs, or claims processing ... These codes are also used by the Medicaid program, but they are not payable by Medicare."
New York Subscriber
Unfortunately, many private payers deny these "S" codes as well, unless you specifically negotiate them into your managed-care agreements.
If your insurer does accept S8037 and S2250, you should use them as an alternative to the unlisted-procedure codes. Their lack of acceptance with the majority of payers, however, makes it difficult to assign these codes with any consistency.
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