CMS status indicator policy

Anduiza05

Networker
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Does anyone know if their commercial payers follow CMS indicator policies (ie, status b, status e)

Also do you know where I can find additional education in regard to how these status indicators work?

I am working for a physician that is receiving statements to pay back procedures based on the CMS policy of status B. I am not familiar with other payers such as BCBS or Aetna following these guidelines.

any help would be appreciated.
 

CodingKing

True Blue
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Payers that align w/ Medicare guidelines (all the big payers) will deny all status B codes b = (Always bundled)

B = Bundled code. Payment for covered services are always bundled into payment for other services not specified. There will be no RVUs or payment amounts for these codes and no separate payment is ever made. When these services are covered, payment for them is subsumed by the payment for the services to which they are incident (an example is a telephone call from a hospital nurse regarding care of a beneficiary).


Appendix for how to use the Medicare Physician Fee Schedule lookup has some additional info on the major RBRVS status indicators

https://www.cms.gov/Outreach-and-Ed...s/downloads/How_to_MPFS_Booklet_ICN901344.pdf
 
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