Wiki 62264 epidural adhesiolysis

[frankmmedbiller]

I do billing for a pain management Dr. and got a denial from BX saying this procedure is experimental I appealed their decision saying this plan is a medicare replacement plan(which it is) and medicare pays it so they should follow. I am at a loss as to how to get this paid any help would be appreciated

 

[tadove1980]

I also work in a pain management speciality, and we have performed this procedure, and unfortunately, we have never got this paid for before, because it is experimental. There is not MC LCD in our region, I'm not sure on your area.

My only advice would be to have pt's sign an ABN stating that is it considered experimental.

Sorry I couldn't help more.