audralynn1979@aol.com
Networker
I am billing 20610 done in an ASC--medicare is denying the claims for procedure code/POS mismatch, my POS is 24... what am I missing--
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Wiki Medicare,injections and Place of service
- Thread starter audralynn1979@aol.com
- Start date
I am billing 20610 done in an ASC--medicare is denying the claims for procedure code/POS mismatch, my POS is 24... what am I missing-nsteinhauser
Expert
20610 has an "ASC Payment Indicator" of "P3." P3 definition is: Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
Our Medicare contractor reimburses $29 for this procedure in an ASC. Not enough to cover the cost of the kit plus staff time. Which is why they need to be performed in an office.
Sometimes our contractor will use an incorrect denial code so it may not be your POS, necessarily - it may be that the diagnosis used is not on the list of 'medically necessary diagnoses' on a LCD with your Medicare contractor or on a NCD with national Medicare. I would check the local Medicare contractor's website first - they always seem to have LCDs on injections and pain procedures.
Hope this helps.
Our Medicare contractor reimburses $29 for this procedure in an ASC. Not enough to cover the cost of the kit plus staff time. Which is why they need to be performed in an office.
Sometimes our contractor will use an incorrect denial code so it may not be your POS, necessarily - it may be that the diagnosis used is not on the list of 'medically necessary diagnoses' on a LCD with your Medicare contractor or on a NCD with national Medicare. I would check the local Medicare contractor's website first - they always seem to have LCDs on injections and pain procedures.
Hope this helps.
Jennifer17
Networker
injection during surgery
we have a physician who wants to bill for an injection 20610 during an ASU procedure - can we code for that? usually the 20610 is for office only , I thought
we have a physician who wants to bill for an injection 20610 during an ASU procedure - can we code for that? usually the 20610 is for office only , I thought