RebeccaWoodward*
True Blue
Hi Gang~
Well...I find myself in unfamiliar territory. CPT code 63040 is not deemed an inpatient procedure on the "inpatient hospital list"; however, the "add on" code, 63043, is considered to be an inpatient procedure. Here's the dilemma. Our surgeons have given orders for 63040 as outpatient. While in surgery, the surgeon determines that an additional level on the spine needs repair (63043). One code is outpatient (63040) and one is deemed inpatient (63043). This is causing some conflict; as you can see. I've been advised from previous colleagues to appeal the POS; which I will. My question....why is the add-on code considered as an inpatient procedure when the parent code is not?? I'm still still researching this...but I thought someone may have encountered this same scenerio. Thoughts?
Well...I find myself in unfamiliar territory. CPT code 63040 is not deemed an inpatient procedure on the "inpatient hospital list"; however, the "add on" code, 63043, is considered to be an inpatient procedure. Here's the dilemma. Our surgeons have given orders for 63040 as outpatient. While in surgery, the surgeon determines that an additional level on the spine needs repair (63043). One code is outpatient (63040) and one is deemed inpatient (63043). This is causing some conflict; as you can see. I've been advised from previous colleagues to appeal the POS; which I will. My question....why is the add-on code considered as an inpatient procedure when the parent code is not?? I'm still still researching this...but I thought someone may have encountered this same scenerio. Thoughts?