Wiki UHC services provided in office vs outpatient place of service

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lilprincess75067

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I have the link to view the UHC Commercial outpatient surgical procedures site of service. My question is this: There are several codes on there such as 20526 -carpal tunnel injection and 20551 - tendon injection that are on that list. We do these in office every day and do not get denials. It makes no sense that these types of codes would be on the same list as 29848 - ECTR and 25000 - Dequervain release and 26111 - Tumor excision (which we do in the office as well for all other carriers including Medicare with no problem). Oddly enough, these same codes are NOT on the UHC Medicare outpatient surgical procedures site of service.
Am I reading the list incorrectly? If not, does this mean I can't do carpal tunnel injections in pos 11? That I need to schedule these as POS 22 or 24?
Any help would be appreciated.

Feeling Frustrated,
Shannon
 
lilprincess75067 said:
I have the link to view the UHC Commercial outpatient surgical procedures site of service. My question is this: There are several codes on there such as 20526 -carpal tunnel injection and 20551 - tendon injection that are on that list. We do these in office every day and do not get denials. It makes no sense that these types of codes would be on the same list as 29848 - ECTR and 25000 - Dequervain release and 26111 - Tumor excision (which we do in the office as well for all other carriers including Medicare with no problem). Oddly enough, these same codes are NOT on the UHC Medicare outpatient surgical procedures site of service.
Am I reading the list incorrectly? If not, does this mean I can't do carpal tunnel injections in pos 11? That I need to schedule these as POS 22 or 24?
Any help would be appreciated.

Feeling Frustrated,
Shannon
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The policy is basically saying that POS outpatient hospital is generally considered medically necessary for the procedures on this list. CPTs that are NOT on the list may possibly be denied as not medically necessary when performed in outpatient hospital, because they are minor and don't necessitate that POS; they should normally be done in office instead unless the patient meets certain criteria listed in the policy that would necessitate performing it in outpatient hospital.
 
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