Wiki Ecmo

[hburns]

Hi, is anyone having trouble with ECMO codes 33960 - 33961? They are listed in CPT as a primary code and an add on code, but they are for initial 24 hrs and subs 24 hrs, and ins is rejecting the add-on codes because they want the initial billed first (every day). My supervisor has been working on trying to get this changed and the answer she gets is that no one else is complaining. It's beyond frustrating! This a very expensive service and now the new books are out and it's still the same!
Thanks!

 

[lking]

Hi, is anyone having trouble with ECMO codes 33960 - 33961? They are listed in CPT as a primary code and an add on code, but they are for initial 24 hrs and subs 24 hrs, and ins is rejecting the add-on codes because they want the initial billed first (every day). My supervisor has been working on trying to get this changed and the answer she gets is that no one else is complaining. It's beyond frustrating! This a very expensive service and now the new books are out and it's still the same!
Thanks!

The best way to bill these is to bill at the end of treatement so you have the primary (mother code) and the add ons on the same claim with different dates of service. We have had not problems getting paid electronically when we did this. Our chapter actually won the Local Chapter Display at the Regional Conference in Springfield MAss this past fall.
hope that helps,
Linda K

 

[hburns]

Thank you!

Thanks Linda, I have been billing them all at once but they still reject for some reason. My opinion is that it's wrong to be listed as an add-on code but we don't seem to be getting anywhere with that argument. If you compare to vent management codes 94002 - 94003, they are also per day but the second code is not listed as add-on and doesn't have the plus sign in front of it. I think that's what the problem is. Would be nice if they would just fix it instead of having to appeal each time. But anyway......thanks for your help and Happy Holidays!