FBCGREGGIE
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Why are add-on codes considered as status "N1" for an ASC? Example: Code 22551 is reimbursable, however code 22552 (add-on) code is "N1" - Packaged service/item; no separate payment made?
The codes should be billed for reporting purposes. Status code N1 is a payment indicator, not a coding guideline - it tells you how the payment is calculated. It doesn't mean that the code is denied or that it shouldn't have been billed. It also doesn't apply to non-Medicare claims. You should code all of the procedures accurately and completely per coding guidelines.Should codes that are packaged in N1 status be billed for reporting purposes, or should they be omitted from the claim entirely? Thank you!
I know this is true...however i don't have source information and a recent audited gave errors on every CPT codes issued that had a N1 indicator...The codes should be billed for reporting purposes. Status code N1 is a payment indicator, not a coding guideline - it tells you how the payment is calculated. It doesn't mean that the code is denied or that it shouldn't have been billed. It also doesn't apply to non-Medicare claims. You should code all of the procedures accurately and completely per coding guidelines.
Sorry to hear of your predicament. I think your superiors have things backwards here. When auditors cite errors, they are the ones who need to provide you with the documentation to show you what guidelines you failed to follow - not the other way around. Otherwise, they are making you 'guilty until proven innocent', which is not the way things should work. Do you have an appeal process when you question or disagree with or don't understand the rationale of an auditor's findings? Does your facility have a written policy that they can show you that says you are not to report codes that have particular status indicators? If not, the auditors have no business citing and error for that. Auditors must audit according to coding guidelines and/or documented policies and they should be able to back up their findings, it's part of their job to do so - they can't just make up their own rules and walk away from it.I know this is true...however i don't have source information and a recent audited gave errors on every CPT codes issued that had a N1 indicator...
I am in desperate need to find documentation from CMS or other coding authority to show I issued the codes correctly....I tried explaining to my BOM and Admin that N1 is a reimbursement policy indicator not a coding rule, but they said I have to show them documentation or the errors stand....
Thomas do you have any source links or can you steer me to where I can find actual documentation that will help me prove I issued my codes correct? I issued 22551, 22552, 22853, 22853, and 20930. the auditor says 22853 x2, and 20930 are all errors as they have a N1 indicator and should not have been reported. Any source documentation regarding reporting codes with N1 would be greatly appreciated. Is there any?