kathrynrr86
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Hello,
We have a few add-on codes being reduced by 50% by Virginia state Medicaid. They are stating that MPR applies. I'm trying to find the resources that show they aren't supposed to be reduced. I saw 2 knowledge base articles on AAPC but they are several years old and the links are not working. The NCCI edit page that they say to reference does not show anything that Add-On codes shouldn't be reduced. Does anyone know where I can find a reference to send to Medicaid showing that Add-On codes are to be paid at 100%. I will note that it is only happening with a few codes (example 22853), but most are being paid at 100%. We are just very confused by what they are saying and doing. Their manual does not mention anything about add-on code reimbursement rates.
Thank you,
Kathryn
We have a few add-on codes being reduced by 50% by Virginia state Medicaid. They are stating that MPR applies. I'm trying to find the resources that show they aren't supposed to be reduced. I saw 2 knowledge base articles on AAPC but they are several years old and the links are not working. The NCCI edit page that they say to reference does not show anything that Add-On codes shouldn't be reduced. Does anyone know where I can find a reference to send to Medicaid showing that Add-On codes are to be paid at 100%. I will note that it is only happening with a few codes (example 22853), but most are being paid at 100%. We are just very confused by what they are saying and doing. Their manual does not mention anything about add-on code reimbursement rates.
Thank you,
Kathryn