palmetto gba

  1. A

    list of chemo drug from Palmetto GBA

    Does anyone have a list from the MAC- Palmetto of their approved meds to be coded with chemo codes? I am struggling to find this. thanks in advance. atwill12100@gmail.com
  2. K

    Palmetto GBA LCD L33445 removal of skin lesions

    Palmetto GBA became our MAC at the beginning of the year. With that comes their LCD L33445 Removal of Benign and Malignant Skin Lesions with (or in this case without) a different set of "covered" or "deemed medically necessary" ICD-10 codes. This has really shook the physicians in terms of...
  3. L

    Help with Modifier for cpt 61635 & 61630

    We recently got a new Medicare MAC which is Palmetto. I am now getting denials for cpt 61630 & 61635 stating I am missing a required modifier. This wasn't required with our old MAC. I've talked to Palmetto several times to no avail as to where to look for the appropriate modifier. I know these...
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    Palmetto GBA- NC area- MSLT LCD L36593 Coding

    Palmetto GBA recently updated their allowed DX codes for sleep studies. The most effected one for us was for the MSLT 95805 codes. It was once allowed to use Hypersomnia as an allowed and now they no longer seem to be allowing symptoms as their only options are diagnosis. But the point of the...
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    Palmetto GBA- NC area- MSLT LCD L36593 Payments

    Palmetto GBA recently updated their allowed DX codes for sleep studies. The most effected one for us was for the MSLT 95805 codes. It was once allowed to use Hypersomnia as an allowed and now they no longer seem to be allowing symptoms as their only options are diagnosis. But the point of the...
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    Palmetto GBA- NC area Sleep Studies & Modifier 52

    Can anyone assist me? I have been having difficulty getting MCR to pay for sleep studies 95810, 95811 if less than 6 hours. According to their LCD it states 6 hours of recording with no mention about what to do for less than 6 hours. But according to CPT AMA if less than 6 hours you need to...
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