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dsg862

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I have a few patients that one of my doctors is honing his skills on using CPT 0184T (Microsurgery with microscope) but Medicare is not paying. I have tried to find resources regarding category III codes, their limitations, special billing needs etc.. but have been unsuccessful. We are in New Jersey. Does anyone understand Medicare and their treatment of category III codes?

Thank you,
Deena
dgreenblatt@surgicalspecialistsnj.org
 
0184T does not exist in the 2008 CPT book

dsg862 said:
I have a few patients that one of my doctors is honing his skills on using CPT 0184T (Microsurgery with microscope) but Medicare is not paying. I have tried to find resources regarding category III codes, their limitations, special billing needs etc.. but have been unsuccessful. We are in New Jersey. Does anyone understand Medicare and their treatment of category III codes?

Thank you,
Deena
dgreenblatt@surgicalspecialistsnj.org
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0184t

I found the answer eventually through a lot of research,

0184T was moved out of category III and made a part of CPT at the July 2007 review, but by then it was not going to make it into CPT 2008. Technically it became effective January 1 2008 as an accepted CPT. Until CPT 2009 is issued, most if not all insurance companies including Medicare will not have it loaded for claim adjudication. Each time it is used and rejected, an appeal has to be done with the documentation from the AMA attached. I am still waiting on the appeal to see what is going to happen. What a pain.

Thanks for you help.
dsg862
 
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