chembree
Guru
Has anyone else experienced any denials for a CT or CTA of the chest where the LCD is incorrectly linked to the LCD for coronary CTA procedures. We have a lot of claims that have denied for this issue with our Medicare advantage plans.
· We have emailed the senior contractor medical director for Cahaba. His only explanation was that the LCDs were loaded per CMS' instructions and he never responded to any future emails.
· We tried the second level appeals process but got the same response basically referring back to the LCDs. We have sent a description of the CPT code for 71275 that describes it as a ‘noncoronary' procedure and highlighted the LCD where it says it excludes these codes.
· Currently we are pulling reports for these CPT codes to show Medicare pays for the diagnosis we have used in hopes they will see the LCD is linked incorrectly.
We are very frustrated with this issue and would love to know if anyone else is experianceing it and what you are doing about it?
LCD # L30047 http://www.cms.gov/medicare-coverag...orgia&CptHcpcsCode=71275&bc=gAAAABAAAAAAAA==&
· We have emailed the senior contractor medical director for Cahaba. His only explanation was that the LCDs were loaded per CMS' instructions and he never responded to any future emails.
· We tried the second level appeals process but got the same response basically referring back to the LCDs. We have sent a description of the CPT code for 71275 that describes it as a ‘noncoronary' procedure and highlighted the LCD where it says it excludes these codes.
· Currently we are pulling reports for these CPT codes to show Medicare pays for the diagnosis we have used in hopes they will see the LCD is linked incorrectly.
We are very frustrated with this issue and would love to know if anyone else is experianceing it and what you are doing about it?
LCD # L30047 http://www.cms.gov/medicare-coverag...orgia&CptHcpcsCode=71275&bc=gAAAABAAAAAAAA==&