CPT C9772

prabha

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My provider did a Intravascular lithotripsy in the tibial/peroneal artery and we have billed CPT C9772 for the same in POS 22 as the patient was admitted and discharged on the same day(facility setting).

Medicare is denying the CPT stating POS is incorrect and it should be 24.

Please advise if anything can be done from the physician side to get it paid.
 

thomas7331

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HCPCS codes that begin with 'C' are for use in facility billing only - physicians cannot bill these codes. If there is no corresponding CPT for this procedure, then you'll need to bill this with an unlisted code.
 

prabha

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HCPCS codes that begin with 'C' are for use in facility billing only - physicians cannot bill these codes. If there is no corresponding CPT for this procedure, then you'll need to bill this with an unlisted code.
Yes, it was billed in a facility setting only...can we change it to a corresponding cpt code?
 

thomas7331

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Yes, it was billed in a facility setting only...can we change it to a corresponding cpt code?
The setting does not determine the code - the type of provider does. Only hospitals billing on UB-04 forms can use the C codes. If you are billing for a provider's professional services with a CMS-1500 form, you will not be able use that code.
 

prabha

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The setting does not determine the code - the type of provider does. Only hospitals billing on UB-04 forms can use the C codes. If you are billing for a provider's professional services with a CMS-1500 form, you will not be able use that code.
Thanks...that's an information...
 
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