Wiki CPT not allowed to be billed in outpt setting

[valariej]

I understand there is a list of codes on the CMS.gov webiste that provides a list of CPT codes that are NOT allowed to be billed/paid in the outpt setting. I have looked and have not been able to locate. I have a payer who says they "loaded" this list in their system and have denied one of our services in an outpt setting as not allowed.
If anyone has the link, would you be willing to share.
Thank you!
Val

 

[mhstrauss]

I understand there is a list of codes on the CMS.gov webiste that provides a list of CPT codes that are NOT allowed to be billed/paid in the outpt setting. I have looked and have not been able to locate. I have a payer who says they "loaded" this list in their system and have denied one of our services in an outpt setting as not allowed.
If anyone has the link, would you be willing to share.
Thank you!
Val

Here ya go. I got to it by Googling "CMS Inpatient Only List 2013", there are several others that came up, this is just the first.

http://www.fideliscare.org/downloads/CMS inpatient only 2013.pdf

Hope this helps!