SSThomas03
Contributor
Does Medicaid reimburse unspecified CPT codes? If they do not, are we allowed to submit a comparison code with an appropriate modifier?
The reason I ask is our facility billed CPT code 46999 with the description, "hemorrhoidectomy, external, single column/group" per documentation and coding guidelines. Unfortunately, we received a denial, code 189, that stated, "Incorrect procedure code billed for procedure/service". Our AR representative called Medicaid and was informed code 46999 was not billable per the provider's credentials, so we are unsure if it is a provider or CPT code billing issue.
The reason I ask is our facility billed CPT code 46999 with the description, "hemorrhoidectomy, external, single column/group" per documentation and coding guidelines. Unfortunately, we received a denial, code 189, that stated, "Incorrect procedure code billed for procedure/service". Our AR representative called Medicaid and was informed code 46999 was not billable per the provider's credentials, so we are unsure if it is a provider or CPT code billing issue.
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