Melissa*Ever*Evolving
Networker
Hello,
For an ASC claim,
If no Prior Authorization was obtained for a specific CPT but was carried out according to the documentation along with other CPT codes that were successfully authorized, should that CPT still be reported on the claim?
We know there will be no coverage but for complete reporting according to documentation, would this be misrepresentation?
This is making me question coding ethics.
We are talking about commercial carriers, not Medicare.
I understand Medicare will only accept the codes mentioned on the ASC Approved OPPS Addendum list.
Please advise.
Thank you in advance!
~Melissa, CPC
For an ASC claim,
If no Prior Authorization was obtained for a specific CPT but was carried out according to the documentation along with other CPT codes that were successfully authorized, should that CPT still be reported on the claim?
We know there will be no coverage but for complete reporting according to documentation, would this be misrepresentation?
This is making me question coding ethics.
We are talking about commercial carriers, not Medicare.
I understand Medicare will only accept the codes mentioned on the ASC Approved OPPS Addendum list.
Please advise.
Thank you in advance!
~Melissa, CPC