CPT 24071 and place of service inconsistent

[dillon091909]

Why can't CPT 24071 be billed with place of service (11)? If not, is there another code that can replace it? I am getting more denials that the place of service is inconstant with the code 24071. It's an Excision of right forearm lipoma.

 

[CodingKing]

Have you called the payer to ask? I wonder if they don't allow surgeries that fall under the category of Major in the office?

 

[dillon091909]

Yea i have called the payers and they say it is not an in office procedure. I have sent chart notes to show it can be done in house but per UHC reimbursement polices CMS is the one that states that CPT 24071 can only be billed by ambulatory surgery centers. HELP!

 

[mitchellde]

If you performed this procedure in the office setting without first alerting your patient that this was a procedure not approved for office setting, then you must write off the entire amount. You can collect no co pay or deductible and you cannot use any other code. You should have a running list of all procedures that are considered not allowed for physician office. Hopefully you do not have too many of these.

 

[CodingKing]

When I was doing my research to answer your question I believe I ran into a UHC policy that was supposed to have a link for the list but I couldn't get it to work