Wiki Sacroplasty Code

[ChattRiskCoder]

Good Morning,

Blue cross is kicking out Sacroplasty codes 200T and 72292. Are these not the correct codes for January 2010?

Any help would be appreciated!

 

[RebeccaWoodward*]

0200T is the correct code; however, BCBS often applies restrictions to category III codes. Many times, these codes are considered experimental and aren't payable. My particular BCBS has a restriction for this procedure...

"Any service or procedure that could be considered experimental or investigational requires prior approval.

Note: Blue Medicare HMO/PPO will not provide coverage for experimental or investigational medical and surgical procedures, equipment and medications, unless covered by Original Medicare or unless, for certain services, the procedures are covered under an approved clinical trial."

 

[ChattRiskCoder]

It printed on our rejection report.....invalid code so I just wanted to inquire.

Thanks!