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Wiki 43117 Partial Esophagectomy

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RedGirl27

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Good Morning:

I am having co-surgeon claims denied just this year for code 43117 stating this is a once in a lifetime procedure and will only be paid to one surgeon.
I have been with this office for 18 years and have never had this type denial. I can find no supporting documentation of this being a once in a lifetime procedure. Does anyone out there know where I may locate documentation. I have searched CMS website, as well as AAPC, and AMA.
Thanks for any assistance. :confused:
 
I would call my MAC and find out 1 - when was it paid before and 2 - where is the policy, NCD or LCD that states this is a once in a life-time procedure. If you are billing a co-surgeon, there is a possibility that something went wrong with the edits and it is bouncing off of the other co-surgeon's payment. But, let your MAC do the work in finding the documentation for you.
 
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