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

Reply
 
Thread Tools
  #1  
Old 07-22-2009, 12:53 PM
cherrera26 cherrera26 is offline
New
 
Join Date: Apr 2007
Posts: 9
cherrera26 is on a distinguished road
Default Medical Necessity for CPT 33249

Hi
We have received a few denials from Medicare of Florida for Procedure 33249 , I have tried to look in CMS to get the Rules and ICD-9 odes that we can use to support the Medical Necessity in several occasions without any success.
Does anybody here has the guide lines or any LCD from CMS with this information.
Please advice.
thanks.
__________________
Camilo Herrera CPC
Reply With Quote
  #2  
Old 07-22-2009, 04:04 PM
cweavercpc cweavercpc is offline
Networker
 
Join Date: Apr 2007
Location: Jackson, TN
Posts: 59
cweavercpc is on a distinguished road
Default Getting paid for AICD's (33249)

Are you billing the code with the Q0 or Q1 modifier? I refered to NCD 20.4 and several MLN Matters Articles:

MM4273 Transmittal# R819CP
MM5805 Transmittal# R1418CP
MM3604 Transmittal# R497CP
MLN Matters Number SE0517

All of this if very useful information and we have been getting paid. I have all of this information scanned and can gladly email anyone who needs it to save you time. Just give me your email address or send me a personal message. Hope this information helps and let me know if you have any questions.
__________________
C. Weaver, CPC, CCC
Reply With Quote
  #3  
Old 07-23-2009, 05:46 AM
cherrera26 cherrera26 is offline
New
 
Join Date: Apr 2007
Posts: 9
cherrera26 is on a distinguished road
Default

no, and I think that is one of the reason we are not getting paid, but I want to be sure that we can use it for Medicare of Florida.
I sent you an email with my Email address and I will really apreciate if you can send me thise documents.
thanks.
__________________
Camilo Herrera CPC
Reply With Quote
  #4  
Old 07-23-2009, 09:22 AM
cweavercpc cweavercpc is offline
Networker
 
Join Date: Apr 2007
Location: Jackson, TN
Posts: 59
cweavercpc is on a distinguished road
Default cherrra26

I just emailed you the documents. Please let me know if you did not recieve them. Hope they help!
__________________
C. Weaver, CPC, CCC
Reply With Quote
  #5  
Old 09-27-2009, 07:55 AM
Bphelps Bphelps is offline
New
 
Join Date: Apr 2007
Posts: 4
Bphelps is on a distinguished road
Default

I would really appreciate any help on the 33249, Florida Medicare Part B keeps denying. Recently, claims were sent with the QO modifier and medicare denied those claims for the QO modifier.

Last edited by Bphelps; 09-27-2009 at 08:00 AM.
Reply With Quote
  #6  
Old 03-13-2011, 12:39 PM
cmsaral cmsaral is offline
New
 
Join Date: Apr 2007
Location: Wichita
Posts: 9
cmsaral is on a distinguished road
Wink Q0 Modifier with LCD to go with it

It not QO that you use its Q0 = Q, (0) :zero not Q, O. it also needs a Diagnosis that Medicare approves.
Reply With Quote
  #7  
Old 04-20-2011, 12:03 PM
ruthwalker ruthwalker is offline
New
 
Join Date: Apr 2007
Posts: 1
ruthwalker is on a distinguished road
Default

Quote:
Originally Posted by cweavercpc View Post
Are you billing the code with the Q0 or Q1 modifier? I refered to NCD 20.4 and several MLN Matters Articles:

MM4273 Transmittal# R819CP
MM5805 Transmittal# R1418CP
MM3604 Transmittal# R497CP
MLN Matters Number SE0517

All of this if very useful information and we have been getting paid. I have all of this information scanned and can gladly email anyone who needs it to save you time. Just give me your email address or send me a personal message. Hope this information helps and let me know if you have any questions.
Hi C. Weaver,
We would truely appreciate any information you have on the AICD and medical neccessity DX...we have just started to get a couple of denials and any information you have would be great...my e-mail is rwalker@ccvmg.com...thanks for your help...
Reply With Quote
  #8  
Old 04-29-2011, 01:26 PM
mandiehead mandiehead is offline
New
 
Join Date: Apr 2007
Posts: 1
mandiehead is on a distinguished road
Default Denials for CPT 33249

Can CPT 33249 only be billed with the Q0 and Q1 modifiers? We perform this procedure, but not for clinical research, therefore those mods seem inappropriate. However, we are receiving many denials from Medicare of Louisiana. Can you please advise? Thanks.
Reply With Quote
  #9  
Old 10-07-2011, 01:32 PM
sueolson sueolson is offline
New
 
Join Date: Apr 2007
Location: Jackson, Tn
Posts: 7
sueolson is on a distinguished road
Default

I would love the info emailed to sue.olson@wth.org
Reply With Quote
  #10  
Old 10-08-2011, 03:44 PM
wassock wassock is offline
True Blue
 
Join Date: Apr 2007
Location: Sarasota FL
Posts: 584
wassock is an unknown quantity at this point
Default 33249q0

To use the Q0 modifier the patient must be Medicare with the dx codes for congestive heart failure and/or cardiomyopathy (non ischemic) 425.4. Also if they have v tach and/or a history of sudden cardiac death V12.53 you would NOT use Q0.
By using Q0 they are showing that the patient has the potential for sudden cardiac death hence the 33249 is being done for primary prevention. Use the Q0 for 33240 for the same reasons when the patients' ICD is at elective replacement time.
Hope this helps.

Last edited by wassock; 10-08-2011 at 03:45 PM. Reason: Heading should be 33249Q0
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 09:50 PM.

AAPC - Top

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