Wiki 95970 & 95972 MCR billing

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EMK

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Brentwood, Tennessee
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As of Oct 5, 2015 we are receiving Medicare denials on our electronic analysis of implanted neurostimulator pulse generator (Interstim reprogramming for urinary incontinence) Our MCO referenced us to NCD 160.7 which omits any reference to the placement of electrodes for urinary incontinence. Prior to ICD 10 this code was billed and paid without issue. Is anyone else having issues in regards to this issue since we are being told this is a national coverage determination?:confused::confused::confused:
 
Yes, the issue is with CMS. They have linked the LCD's to all neurostimulators such as the brain and anything urinary is getting denied. I reached out to Medtronic and I was advised to file an appeal for every claim that CMS denies. Medtronic is working with CMS to get this issue resolved. The more people that appeal could get this issue resolved faster. I have made note of all the claims I have and will appeal them all. This is ridiculous!:mad:
 
Thank you for your response that is what we have been told as well. I have submitted many appeals hopefully they will rectify soon :rolleyes:
 
Our office is also having this issue, we did an appeal and it too was denied. For now we are holding the claims. They are also denying 64590 for the same reason. :(
 
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