brittanywitte
Guest
Good morning!
I'm having some issues with Medicare incorrectly applying an MPPR to our holter monitors 93224. From my understanding of the MPPR rules there must be more than one procedure billed for the MPPR to apply. I am billing one single cpt 93224 but Medicare is automatically applying the MPPR. Medicare's reasoning for this is because 93224 has one pro fee code and two tech fee codes because of this "anytime 93224 is billed it will automatically have MPPR applied regardless of how many procedures are on the claim". I have tried appealing to Medicare all come back unfavorable I have appealed to the next level C2C and about half come back favorable and half unfavorable.
Anyone else having this issue or know any different information that I don't.
Thank you!!
I'm having some issues with Medicare incorrectly applying an MPPR to our holter monitors 93224. From my understanding of the MPPR rules there must be more than one procedure billed for the MPPR to apply. I am billing one single cpt 93224 but Medicare is automatically applying the MPPR. Medicare's reasoning for this is because 93224 has one pro fee code and two tech fee codes because of this "anytime 93224 is billed it will automatically have MPPR applied regardless of how many procedures are on the claim". I have tried appealing to Medicare all come back unfavorable I have appealed to the next level C2C and about half come back favorable and half unfavorable.
Anyone else having this issue or know any different information that I don't.
Thank you!!