Wiki Substitute skin graft in office 15271

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DRBasel1045

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Benson, AZ
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Need some help. pt came in and had substitute skin graft done in the office for an open wound of the buttocks. the coder billed out 15271 but the insurance AHCCCS Denied out stating "procedure code/bill type is inconsistent with place of service" I cant find anything that tells me I can not bill 15271 for POS 11. Does anyone have an idea where I can find information telling me either I can or can not bill so I can appeal this again. One appeal has been done but they came back with the same reason.
 
Most skin grafting is considered Hospital OR only procedures. There is (or at least use to be) a list on the Mcare website of Hospital only procedures. Check you regional Mcare website. Most payers go by Mcare.
 
Thanks Debra,
I do have the inpt only list for Medicare for 2013 (which is where these claims fall) and the code is not on there I will try and appeal using they normally follow Medicare guidelines and see what happens. thanks for your help!

Dawn
 
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