Billing Category III codes

elohrenz

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Can anyone tells us how you set your fees for those Category III codes that have not been give reimbursement rates by CMS? In particular the codes 0114T, 0145T, 0146T etc.

Thanks
Betty
 
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Category III

I have a question. In the practice that I work, they are not coding 0146T etc, because is not payable or because the Insurance company will not have the code on their system foe authorization, therefore my office is billing CTA non coronay. Is this is correct? My undertanding is not a code for the CTA coronary we are to used cat III codes? Please advise
 

aklein

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We have had a lot of trouble with most major managed care's paying for the "T" codes. I'm sure you know BCBS and Aetna will not pay no matter what you code or send. Most of the CT"s that we get paid on are from "off the wall insurance companies". One of the major companies we were having trouble with was UHC. We were billing 0147T and getting denials requesting med. rec's. Once sent they would deny again stating "experimental". We were able to talk to one of the big wheel's over there and were told to bill 0146T and send with report and LMN. Now UHC is paying on 85+% of our CT's.
 

lswindull

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Category III Codes

In houston we have to same difficulty with billing and reimbursement for Category III Codes.

Are other Cardiology Practices billing for 0126T and how much are you billing for this service. TrailBlazer's list this service as non covered.
 
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