Wiki Pacemaker checks remote

[GBielskis]

Is anyone else getting denials for pc 93294 PM check remote - patient at home

Per Medicare guidelines as of April 1, 2013, the place of service should be 12 home when the patient is located at home with a pacemaker check 93294 remote
We are being denied by Medicare J8MAC Michigan. E-news dated 040913 stated the billing should be the POS where the patient is located - i.e. home 12 (if patient was at home) effective 040113.
It also stated this in MLN Matters March 29, 2013 for CR7631.

We are being denied for the dates of service after 040113 because of the place of service billed as 12.

When Medicare is contacted, they are stating the patient's home address has to be on the claim for the place of service. We do a lot of PM checks and could not possibly put the patient's home address on the claim, as this varies for every patient.

Anyone else having this problem? Are we interpreting the above incorrectly?

 

[CPCCODERII]

We have not billed any of these as of yet, but we are also anticipating denials. Medicare clearly stated that the address that needs to be on the HCFA is the providers address, and the place of service should be where the patient was at, at the time of the technical portion of the test. We have to go into each claim to correct this manually, as our system will not populate this automatically...ugh it has been a headache for us. So, by us manually entering, we are putting the facility as the providers physical address box 32A and the place of service should be the patients location box 24B. If this is how you are billing, I would keep fighting this and refer them back to their own transmittals which show that you did bill correctly.

Sorry I dont have any specific information, just wanted to share that you are not alone