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Good day everyone,
According to BCN Medicare Advantage plan procedures 64493-64494 and 64635-64636 are nonpayable as they are deemed questionable nature procedure based off the Hospital Outptatient Prospective Payment System. This makes no sense to me since we are just an office and are not an ambulatory service center. In June there was no problems, but July is a whole different story and I did not see anything on the newsletter from them either. Has anyone else expierenced this issue? I am appealing these claims, but that takes 45 business days and patients want pain relief.
According to BCN Medicare Advantage plan procedures 64493-64494 and 64635-64636 are nonpayable as they are deemed questionable nature procedure based off the Hospital Outptatient Prospective Payment System. This makes no sense to me since we are just an office and are not an ambulatory service center. In June there was no problems, but July is a whole different story and I did not see anything on the newsletter from them either. Has anyone else expierenced this issue? I am appealing these claims, but that takes 45 business days and patients want pain relief.