Neurosurgery Coding Alert

Here's how to capture pay if wrong location is due to extra vertebrae. If your neurosurgeon performs a procedure on the wrong spinal level, you should hold off seeking any payment from Medicare. Future transmittals will instruct payers how to implement three final national coverage decisions (NCDs) specifying non-coverage. As of Jan. 15, CMS specifies it will not cover surgical or other procedures when the physician performs: - a procedure on the wrong body part - a procedure on the wrong patient - the wrong procedure. Bottom line: If you bill for procedures that meet any of the above stipulations and receive reimbursement, you could be facing a recoupment request at some future date. -If the doctor made a mistake, the patient should not have to pay for it, nor should the insurance company,-says Christine M. Bitner, CPC, CPC-I, chart abstraction specialist at HCA Physician Services in Brentwood, Tenn. -Hopefully [...]