Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > Medicare Regulations
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 10-08-2013, 01:24 PM
livingitupinok livingitupinok is offline
Contributor
 
Join Date: Apr 2007
Posts: 18
livingitupinok is on a distinguished road
Default Medicare and 15100 and 15101

I am working on coding for an ASC center. I have billed 15100, 15101 and 15002. Medicare is not paying the base code 15100. Can someone give me insight on this. I am new to coding/billing for Medicare. I have asked another coder who says that Medicare doesnt pay the base code sometimes. HELP
Reply With Quote
  #2  
Old 10-08-2013, 01:43 PM
mitchellde's Avatar
mitchellde mitchellde is offline
True Blue
 
Join Date: Apr 2007
Location: Columbia, MO
Posts: 8,304
mitchellde will become famous soon enoughmitchellde will become famous soon enough
Default

I do not feel it is correct to say that they routinely do not pay the base code. It may have to do with the way you listed them on the claim and in conjunction with what ICD-9 Code. Can post more detail?
__________________

Debra A. Mitchell, MSPH, CPC-H
Reply With Quote
  #3  
Old 10-09-2013, 12:43 PM
livingitupinok livingitupinok is offline
Contributor
 
Join Date: Apr 2007
Posts: 18
livingitupinok is on a distinguished road
Default

We get our ASC coding from someone off site, then I try to fox it when it rejects
She coded it as follows: All using the ICD-9 code 709.2
15100, 15101, 15002-51
15100, 15101-51
they pd all but the 15100.

they repaired two seperate areas
Reply With Quote
  #4  
Old 10-09-2013, 01:03 PM
mitchellde's Avatar
mitchellde mitchellde is offline
True Blue
 
Join Date: Apr 2007
Location: Columbia, MO
Posts: 8,304
mitchellde will become famous soon enoughmitchellde will become famous soon enough
Default

Quote:
Originally Posted by livingitupinok View Post
We get our ASC coding from someone off site, then I try to fox it when it rejects
She coded it as follows: All using the ICD-9 code 709.2
15100, 15101, 15002-51
15100, 15101-51
they pd all but the 15100.

they repaired two seperate areas
So these codes were all billed on the same claim? as in you have 15100 billed twicw and 15101 billed twice and 15002 billed once? Also the dx code for a scar, what is this scar from? is it due to a burn or is it keloids from a laceration? If so there needs to be another dx code for this such as a 905 code for late effect. Also the prep of of the surgical site does not match to the graft code, meaning you prepped 100 sq cm but then billed in excess of 100 sq cm of grafting, also if two separate areas are repaired you do not bill separate with these codes you add the entire amount together. More info is definitely needed but I feel this was not coded appropriately at all.
__________________

Debra A. Mitchell, MSPH, CPC-H

Last edited by mitchellde; 10-09-2013 at 01:08 PM.
Reply With Quote
  #5  
Old 10-09-2013, 03:08 PM
livingitupinok livingitupinok is offline
Contributor
 
Join Date: Apr 2007
Posts: 18
livingitupinok is on a distinguished road
Default

Thank you neither did I, but I wanted to make sure of this since I dont do ASC before I went to my supervisor.

Have a great day
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 12:13 PM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC