wondercheka
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Hello, folks.
The claims processor is stating that our professional component claims for PET and PET-CT scans that include the PI modifier must also include HCPCS code A9552. They are citing the Medicare Claims Processing manual sections 60.3.1 and 60.3.2 as well as NCD 220.6.17 as their source for this requirement. From what I can find, A9552 has a status indicator of N and is paid under OPPS.
A9552 is a supply and can only be billed by the facility, correct? Does anyone have any other citations to offer to our claims processor that their position is incorrect?
The claims processor is stating that our professional component claims for PET and PET-CT scans that include the PI modifier must also include HCPCS code A9552. They are citing the Medicare Claims Processing manual sections 60.3.1 and 60.3.2 as well as NCD 220.6.17 as their source for this requirement. From what I can find, A9552 has a status indicator of N and is paid under OPPS.
A9552 is a supply and can only be billed by the facility, correct? Does anyone have any other citations to offer to our claims processor that their position is incorrect?