Wiki Ultrasling denials day of surgery

[eviec2869@gmail.com]

We haven't had problems until just recently, but now we are getting denials and recoups for Ultraslings billed on the same day as shoulder surgery. A previous biller had been putting just them in with a different POS (not sure why) and they seemed to be passing inspection and being paid. But now not. I am planning to get my MDs to fit the sling during the pre-op appt and hoping this will solve the problem and follow proper billing protocol, but I'm just wondering if anyone else has had problems or has any insight. Thanks

 

[fltbaroque]

Is this a Medicare patient? Our DME MAC requires that we use place of service home for Medicare. We use POS home for commercial insurance as well. I can't answer anything regarding the date of service other than we usually dispense the DME prior to or after the surgery, so I'm not sure if having the same date of service is the issue. Also, we use a KX modifier on DME for Medicare.