Wiki Ivus cpt 37250

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kbryant

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Is anyone experiencing issues with Medicare not paying for CPT 37250, 37251 if the primary code is 36010, 36011, or 36012. Apparently our Medicare carrier for NE has a new policy for primary codes effective 04/01/13 and these codes are no longer valid. Stent insertion is bassically the only primary code they allow. If the ultrasound findings of stenosis in not significant enough to warrant stents we aren't being paid.

If there a different way to bill this? I have tried appealing this with the carrier but they are denying the appeal per their policy.
 
kbryant said:
Is anyone experiencing issues with Medicare not paying for CPT 37250, 37251 if the primary code is 36010, 36011, or 36012. Apparently our Medicare carrier for NE has a new policy for primary codes effective 04/01/13 and these codes are no longer valid. Stent insertion is bassically the only primary code they allow. If the ultrasound findings of stenosis in not significant enough to warrant stents we aren't being paid.

If there a different way to bill this? I have tried appealing this with the carrier but they are denying the appeal per their policy.
Click to expand...

Can you post the operative report? Not really sure what your doing?
Thanks,
Jim Pawloski, CIRCC
 
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