Reader Question:
Fee Reductions on 57282 and 57260
Published on Wed Aug 01, 2001
Question: We billed 57282 for a sacrospinous fixation and 57260 for an anterior and posterior repair. Why did the carrier significantly reduce the fee?
California Subscriber
Answer: Code 57282 (sacrospinous ligament fixation for prolapse of vagina) has a slightly higher relative value unit than 57260 (combined anteroposterior colporrhaphy), but the carrier may not attach as high a value to the surgery, so it considers 57282 as the lower-valued service. But if you listed 57282 first on the claim, you should have been paid the full allowable amount for it with a fee reduction on 57260. The payers usually discount the second procedure by 50 percent because they are now paying you only for the additional intraoperative work.
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