solocoder
Expert
I am confused by this one. Could someone help me interpret this, please?
Patient had foot surgery by a podiatrist and post op hemorrhage the following day. Medicare denied 35860 for ligation of bleeder. Claim adjustment code shows: Payment is adjusted when performed/billed by a provider of this specialty. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. This change effective September 1, 2017: Payment is adjusted when performed/billed by a provider of this specialty. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
"Change effective September 1,2017"??? So how does it apply to a surgery done May 17? Also, I don't see that it was "adusted" just denied.
Woud there be any hope of getting this paid on appeal?
Patient had foot surgery by a podiatrist and post op hemorrhage the following day. Medicare denied 35860 for ligation of bleeder. Claim adjustment code shows: Payment is adjusted when performed/billed by a provider of this specialty. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. This change effective September 1, 2017: Payment is adjusted when performed/billed by a provider of this specialty. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
"Change effective September 1,2017"??? So how does it apply to a surgery done May 17? Also, I don't see that it was "adusted" just denied.
Woud there be any hope of getting this paid on appeal?