AmandaM2153
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I came from a hospital billing and coding and am now with a Clinic. I am kind of lost as to why the difference between the two for coding and billing and am wondering if anyone can help.
First of all, we do scopes in the clinic under MAC anesthesia. Medicare is denying a colonoscopy against an egd as being "allowed in another procedure" - but why would this be if the two scopes are in different parts of the body and are through different enterances?
Also I have been billing for Versed and Propofol under the CRNA that is performing our anesthia but Medicare states that they do not pay for those for a CRNA - any way to get around that or any advice as to what my next step would be?
And my third question is when we would bill colonoscopies for the hospital we would bill for everything together, like biopsy, polypectomy, removal w/snare, etc depending on what was performed. When I tried to code everything like a biopsy and polypectomy together Medicare denied the one against the other, why would this be even though they were reimbursed together under a hospital form.
Any insight would be greatly appreciated, there are no other surgery clinics around that are the same set up as us to bounce ideas/questions off of. Also another thing to keep in mind is we are not certified by medicare as an ASC yet - i am working on getting the paperwork and survey done.
Thank you!
First of all, we do scopes in the clinic under MAC anesthesia. Medicare is denying a colonoscopy against an egd as being "allowed in another procedure" - but why would this be if the two scopes are in different parts of the body and are through different enterances?
Also I have been billing for Versed and Propofol under the CRNA that is performing our anesthia but Medicare states that they do not pay for those for a CRNA - any way to get around that or any advice as to what my next step would be?
And my third question is when we would bill colonoscopies for the hospital we would bill for everything together, like biopsy, polypectomy, removal w/snare, etc depending on what was performed. When I tried to code everything like a biopsy and polypectomy together Medicare denied the one against the other, why would this be even though they were reimbursed together under a hospital form.
Any insight would be greatly appreciated, there are no other surgery clinics around that are the same set up as us to bounce ideas/questions off of. Also another thing to keep in mind is we are not certified by medicare as an ASC yet - i am working on getting the paperwork and survey done.
Thank you!