Wiki Manipulations - SINCERELY APPRECIATE INPUT

East Coast

Guest
Messages
3
Best answers
0
Would love another opinion on how to bill an operative note that reads:

Manipulation of shoulder (under anesthesia)
Manipulation of knee (under anesthesia)

I billed 23700 and 27570-51

Also would like an opinion on what our insurancer carrier did based on their system and how it interprets the mulitple surgery rules.

When I billed a local medicaid carrier of our they changed our claim to read:

27570 - denied payment based on mulitiple surgery rules
23700-51 - paid at 50% of allowed charge
27570-51 - paid at 50% of allowed charge

I have not seen this done before, personally think it's unethical to change our claim and feel that our 1st procedure should be paid at the allowed rate and the 2nd procedure be reduced accordingly.

What do you think? THANKS SO MUCH!!!!
 
I just ran this through Ingenix and use of 51 over 59 is correct. Also, you should bill out in RVU order to maximize your reimbursement.
 
Top