Wiki billing for 62321

More information would be helpful. What does the denial say? Who is the payer? Are you billing the denied service with any other codes?
 
More information would be helpful. What does the denial say? Who is the payer? Are you billing the denied service with any other codes?
this claim that I am working on is for Medicare. The other codes are J1100, Q9966 and A4550 and the ICD-10 codes are M542, M47812 and S134XXA.
 
Your best bet is to start with your MAC's LCD and companion article for epidurals. For example, the article will have the diagnosis codes that are covered for the service.
 
MCR does not reimburse for A4550, for us here in NY they do not even pass through EDI. Also your DX codes are incorrect. DX M54.2 should be M54.12 for Cervical Radiculopathy and DX code M47.812 will never, ever, ever be reimbursed on any epidurals. You must have radiculopathy symptoms for epidurals and DX M47.812 is Spondylosis without myelopathy or radiculopathy, cervical region.
Know this is an old post but figured if people were searching this would help.

Elizabeth Hauner
Sr. Pain Management Biller
 
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