caromissunc1
Guest
- Messages
- 123
- Best answers
- 0
I sent in a claim as OP for a Tricare patient using the codes 22551, 22851 & 22845. The claim denied because 22845 is an IP code only per CMS rules. However, Medicare pays these whether IP or OP.
Also, I haven't been sending out shoulder scopes for Medicare with anything more than 29827 even when more is done because of the new orthopedic CCI rules for 2014 stating that the shoulder is one anatomic site and only code is allowed. However, I have heard that other coders code out everything and get paid. Tricare, however, follows this CCI edit to the letter and will deny any other codes.
Has anybody else noticed this? If we can paid for all shoulder codes for MCR patients, then GO FOR IT!
Also, I haven't been sending out shoulder scopes for Medicare with anything more than 29827 even when more is done because of the new orthopedic CCI rules for 2014 stating that the shoulder is one anatomic site and only code is allowed. However, I have heard that other coders code out everything and get paid. Tricare, however, follows this CCI edit to the letter and will deny any other codes.
Has anybody else noticed this? If we can paid for all shoulder codes for MCR patients, then GO FOR IT!