Wiki kyphoplasty

[Jennifer Lynn Williams]

I am getting denied for billing a kypho billed in a office setting, when did this change? and is anybody else? I have checked with Indiana and Michigan for in office setting billing 22513 and 22514 and both say no anymore.....I have not seen any information out on this......

 

[jburkert@michiganbillingservice.net]

Kyphoplasty

We are also getting denials from Medicare (Michigan) CO-5 stating the place of service is invalid for our Kyphoplasty procedures in an office setting. Our Neurosurgeons have been performing these in the office setting for a longtime with no issues.

When we called Medicare they stated it is an "Internal guideline with Medicare that can't be released". We asked Medicare if the LCD has been changed or revised, they said nothing has been posted about it. They are telling us to do a re determination on them.

What are we supposed to redetermine? Has anyone been able to get more information from Medicare?

Thank you!

 

[emilykbennett]

Good morning,

I am still having trouble with this same issue (in Kansas) for kyphoplasty performed in POS 11. Were you able to appeal these successfully? Thank you for your assistance!

 

[Stephanie4602]

We are getting denials as well stating procedure is "experimental/investigational". Does anyone have any updated information on this?