Wiki Vascular

[jgray2006]

I Was Wondering If Anyone Can Help Us With A Problem.. We Have A Vascular Dr That Insists That All Add On Codes Need To Be Pd In Full Along With The Primary Code. An Example Of This Is
36475 And 36476. Dr Expects Both Codes To Be Pd In Full As A Par Dr. Any Help Will Be Greatly Appreciated

 

[LLovett]

Are they paying them correctly per their fee schedule?

Being an add on code the reimbursement is lower than the primary code because the RVU is much lower. Medicare pays based on RVU, not the fee submitted, is that what he is expecting to get in full?

Pull up the medicare fee schedule and show him what they approve for those codes, hopefully that will help. I am assuming he knows they only pay 80% of what they approve and that is not his issue.

Good luck,

Laura, CPC

 

[jgray2006]

Thank You For The Insight.... I Appreciate It... As Far As We Can Tell He Is Being Pd In Full Per The Par Fee Schedule...