Wiki 29824

[judithdoss]

Hello everyone,
Lately I have been receiving denials from Work Comp carriers stating that in order to bill for a distal claviculectomy(29824), 8.0 to 10mm has to be removed in order to bill with other codes such as 29827,29826. Medicare has no such restrictions. AAOS had a stipulation back in 2004 that it had to be 1cm, but apparently that has been removed. I can't seem to find anything in writing. Can someone help!

Thanks,
Judy

 

[mitchellde]

work comp is not a HIPAA covered entity and therefore they do not have to adhear to a standard definition for a procedure. So you have to follow work comp rules when dealing with work comp.