rizeninme
Networker
We just received denials today on the new infusion codes. We billed 96367 as an add-on code along with 96365 (per 2009 CPT guidelines) but Medicare denied 96367 saying that they do not pay for add on codes unless they are billed with the primary code. When we called to explain that we did bill the appropriate primary code, we were told that their computer does not show that 96365 is the primary code for 96367, and that the only thing we can do is appeal. They of course would not tell us what the primary code is for 96367.
Has anyone else gotten this denial? Should we just appeal, or should we call back and try to work up the tiers to get someone who can understand and help us?
Has anyone else gotten this denial? Should we just appeal, or should we call back and try to work up the tiers to get someone who can understand and help us?