We have received a couple denials from Medicare for total knee arthroplasties stating "Your Part B claim cannot be paid as the hospital's Part A claim has been denied for not medically necessary".
The hospital's coding matches ours and should have paid as far as we can see. I do recall hearing something recently about Medicare changing the protocol guidelines for total joints but I cannot remember where I heard it or read it. I have attempted to find a new policy on the CMS website but it just brings up a bunch of junk that have nothing to do with what I'm looking for.
Any thoughts or advice? We would really appreciate it!!
The hospital's coding matches ours and should have paid as far as we can see. I do recall hearing something recently about Medicare changing the protocol guidelines for total joints but I cannot remember where I heard it or read it. I have attempted to find a new policy on the CMS website but it just brings up a bunch of junk that have nothing to do with what I'm looking for.
Any thoughts or advice? We would really appreciate it!!