dmalone178
Contributor
I am in the middle of a debate between one of our physicians and a payer (med advantage plan).
The physician coded a 27095 (Injection procedure for hip arthrography; with anesthesia)with a 77002 (Fluoroscopic guidance for needle placement). The insurance company is saying that it needs to be down coded as a 20610 w/fluoro because the doctor did not document the interpretation of the arthrogram. I have searched and searched for documentation guidelines everywhere I can think of and have come up with nothing (the payer says they follow CMS guidelines).
Can anyone tell me where they are hiding them (the guidelines)so that I can take it to the physician and have him do an addendum?
Any help would be greatly appreciated
DMalone, CPC
The physician coded a 27095 (Injection procedure for hip arthrography; with anesthesia)with a 77002 (Fluoroscopic guidance for needle placement). The insurance company is saying that it needs to be down coded as a 20610 w/fluoro because the doctor did not document the interpretation of the arthrogram. I have searched and searched for documentation guidelines everywhere I can think of and have come up with nothing (the payer says they follow CMS guidelines).
Can anyone tell me where they are hiding them (the guidelines)so that I can take it to the physician and have him do an addendum?
Any help would be greatly appreciated
DMalone, CPC