• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki CPT/ASA help

Create Wiki
L

lcole7465

Expert
Messages
292
Location
Brooklyn, MI
Best answers
0
I am stumped. A rigid esophagoscopy with a removal of a foreign body on a 10 month old. The only cross in the crosswalk is 00320, which is for 1 year of age or older.

[B]The patient was brought to the OR and placed on table in supine position. After induction of general anesthesia, she was placed on a shoulder roll with her neck extended. Rigid esophagoscope was passed through the mouth into the proximal esophagus where a penny was visualized and then this was grasped with an alligator grasper and removed along with the scope. There were no mucosal changes identified. The patient tolerated the procedure well and was returned to the Recovery Room in good condition.[/B]

The surgeon billed 49134, which is the correct code and was paid, but the payor is denying the anesthiology claim due to the ASA.

Any input would help.
 
It's a Medicaid claim, so the 99100 wouldn't apply since Medicaid doesn't pay for age. I'm maybe thinking that even though there is only 1 cross in the crosswalk, we can still add 00326 as an alternative cross.
 
Last edited:
You must log in or register to reply here.
Top