If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Is anyone else getting denials from Medicare for the add-on debridement codes stating the units of service exceed the maximum allowed? What is the trick to getting multiple units of service paid?
Thank you in advance for help with this.
Is anyone else getting denials from Medicare for the add-on debridement codes stating the units of service exceed the maximum allowed? What is the trick to getting multiple units of service paid?
Thank you in advance for help with this.
I actually called Trailblazer and asked them why they denied the add on code. I was told there was no way the debridement could have been as extensive as what we billed. Thank I sent the picture of the leg of the 5 foot, 250 plus patient with the extensive debridement, as well as documentation for the wound therapist who also treated the leg,
that described the exact same measurements as my surgeon. They paid.
We've been getting these denials and I found a conversation on another forum that suggesting billing no more than 3 units on each line. We're going to try that.
I was getting denials also so now anytime I am going to code more than 3 units per line for these I add a box 19 note "addl information available upon request". We provide the op note and then we get paid.