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Debating Question and concern about changed a OB ultrasound code from a Full to limited for INS to pay.
example only:
Provider sees an OB patient at 22 weeks and he is doing a FULL (76805) ultrasound for basic anatomy screening with no problems. The ins will only pay for one FULL OB ultrasound when no problems are noted and patient already had one done and it was paid. but the INS will pay for a limited 76815 with no problems. My question is, can you change the code from 76805 to 76815 to get INS to pay for the lesser part? to get some type of reimbursement?
I was under them impression, we code what the provider did and if the INS does not cover it, we have to write it off instead of changing the code to get paid. I hope my question makes since.
Any advice would be greatly appreciated.
Thank you.
example only:
Provider sees an OB patient at 22 weeks and he is doing a FULL (76805) ultrasound for basic anatomy screening with no problems. The ins will only pay for one FULL OB ultrasound when no problems are noted and patient already had one done and it was paid. but the INS will pay for a limited 76815 with no problems. My question is, can you change the code from 76805 to 76815 to get INS to pay for the lesser part? to get some type of reimbursement?
I was under them impression, we code what the provider did and if the INS does not cover it, we have to write it off instead of changing the code to get paid. I hope my question makes since.
Any advice would be greatly appreciated.
Thank you.