punkyboo
Networker
I am at my wit's end with this.
We are billing with cpt code 88172 (Cytopathology, evaluation of fine needle aspirate) for 4 units, because the evaluation was done on 4 different specimens.
An Anthem rep told me they only pay $52 for a total of 1 unit. Curious, I called Medicare to see how if they allow for billing of units...and was told yes, but 4 units is too many! And of course, she could not tell me the max number that can be billed.
She did direct me to the Medically Unlikely Edits on www.cms.hhs.gov, but all I can is an Excel spreadsheet with 2 columns...the first has the hcpcs/cpt code, the other has the Medically Unlikely Edits and there is a single number after each hcpcs/cpt code.
Am I missing something here? All I wanted to know was how many units I could bill for cpt code 88172
Anybody have any ideas, on the original question, or even how to read the Medically Unlikely Units spreadsheet???
Thanks,
Kat
We are billing with cpt code 88172 (Cytopathology, evaluation of fine needle aspirate) for 4 units, because the evaluation was done on 4 different specimens.
An Anthem rep told me they only pay $52 for a total of 1 unit. Curious, I called Medicare to see how if they allow for billing of units...and was told yes, but 4 units is too many! And of course, she could not tell me the max number that can be billed.
She did direct me to the Medically Unlikely Edits on www.cms.hhs.gov, but all I can is an Excel spreadsheet with 2 columns...the first has the hcpcs/cpt code, the other has the Medically Unlikely Edits and there is a single number after each hcpcs/cpt code.
Am I missing something here? All I wanted to know was how many units I could bill for cpt code 88172
Anybody have any ideas, on the original question, or even how to read the Medically Unlikely Units spreadsheet???
Thanks,
Kat