Wiki can cpt 22612 be billed on an OP claim?

[cjagustin]

I am using Nthrive which calculates the expected reimbursement for outpatient claims. It has an expected reimbursement for CPT 22612, so I am assuming that it is an OP procedure. When the claim was submitted to Humana Medicare, it denied the procedure because it is an IP procedure billed on an OP claim. Can CPT 22612 be billed in an OP claim? Since it was billed to a Medicare Advantage plan, where in the Medicare website can I find a list of IP procedures that can be billed on an OP claim? I appreciate very much all the insights/inputs/resources.. Looking for this particular information in the Medicare website is daunting...Thank you.

 

[CodingKing]

I don't see it on the inpatient only list. It doesn't have APC indicator of C

For the list download the latest OPPS Addendum B. SI column will list C if its on inpatient only list

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Addendum-A-and-Addendum-B-Updates.html

 

[cjagustin]

I don't see it on the inpatient only list. It doesn't have APC indicator of C

For the list download the latest OPPS Addendum B. SI column will list C if its on inpatient only list

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Addendum-A-and-Addendum-B-Updates.html

thank you very much!!!