medicare denials

  1. K

    Wiki 3 Major joint 20610 in one day

    We have a few providers that will perform multiple injections in one day for example Bilateral Knee and RT Shoulder. Medicare will pay the bilateral line then deny the third injection as missing/invalid modifier with no appeal rights. If there is a MUE of 2 for 20610 should we be performing a...
  2. E

    Wiki Billing Radiopharmaceuticals under Medicare

    We routinely bill nuclear stress tests (78542) along with TC-99m (A9502). Several months ago, Medicare began denying code A9502 saying they need the paper invoice for the drug on file, which seemed egregious. We called Medicare, who said to include the name of the drug, the dosage, and the...
  3. C

    Wiki Medicare Denials? - Pellet Insertion 11980

    Is anyone having Medicare denials for pellet insertion/female hormone therapy? CPT 11980- Pellet Insertion Thanks!
  4. K

    Wiki CO-170 (Medicare denials)

    Anyone else having issues with claims denying with CO-170? We have several NPPs that have always ordered labs and mammograms and are now having their claims (randomly) deny with CO-170 and I can't find anything anywhere stating they aren't able to order these tests. We have called (numerous...
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