Wiki Help, problems getting 45330 paid

[GLaycock]

Can anyone suggest how I can get a claim for a 45330 paid for Intractable rectal pain and internal hemorrhoidal disease through Medicare? Have used both rectal pain and hemorrhoids.

 

[cynthiabrown]

Did you bill office visit on samr day?

 

[GLaycock]

No, patient was not seen in the office.

 

[mitchellde]

Was the hemorrhoids the finding upon performing the scope? If so use only the hemorrhoids. If the documentation suggests that the hemorrhoids were only an incidental finding having nothing to do with the rectal pain then I would code only the rectal pain for the procedure.
When the finding explains the presence of the symptom, guidelines tells us to code only the finding, do not code both.
I am not saying that this is the problem, only a suggestion.

 

[TAMCAMP]

we bill this 45330 as outpatient frequently and do not have any problems.. The code I use for rectal pain "was" 569.42 and had one pay today actually

 

[chewri]

we've had to have 45330 added to our contracts. Is a procedure that used to be done in the Dr.'s office and now mostly in ASC's.