Does anyone know what the MCR remit advice adjustment code CO-58 really means? We are getting these adjustments on colonoscopy/endoscopy procedures but are getting the correct payment for facility place of service. Medicare has not been forthcoming with any information. Thanks!!
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Wiki Medicare remit advice
- Thread starter apower66
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so who are you billing for the physician or the facility? The last page of your remit will tell you what the descriptors are for co-58. to me it appears to be that you are using the wrong place of service code for the physician, but that is just a guess.
who are you billing for and what type of facility is the procedure being done? I do a lot of endoscopy billing for a facility so let me know.
Caprice-CPC
Physician billing...he does not have an ASC so colon/egd procedures are done outpatient at a local hospital. Therefore POS billed is 22. I heard that this CO58 is associated with many adjustment reasons but MCR will not answer specifics. I was also told it might be the adjustment reason due to the fact the doctor is not getting the full reimbursement but rather the facility fee due to 22 POS vs 11?
hlmcintyre
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Did they not include a remit code (usually an M or N code)? Claims that have a denial code usually include some type of remit code on the left side that usually make more sense than the OA and CO codes.