tiavrban
Contributor
Hi all. I would like some input on the following scenario: my surgeon has a 15 yo patient that he wants to do an OATS of the elbow. Insurance will not cover as they consider it investigational. He wants me to bill the insurance for the surgery part (unlisted billed for this because there is not a CPT code) and bill the patient for the graft. I do not think we can do that do to our contract with the insurance company. Not only that, but I believe insurance will deny anyway, for investigational. Please share your thoughts so I can say I did my due diligence. My thought is that we either bill insurance and not get paid, or have patient be self pay and responsible for the whole surgery.
I look forward to any feedback.
Thanks,
I look forward to any feedback.
Thanks,