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nyyankees

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I have an issue here. One of our Dr's does arthrocopic FAI's and pretty much does a synovectomy (29863) and labral debridement (29862). We got paid on the 29863 + 29862 and when we appealed the unlisted 29999 (FAI) they finally paid it.

BUT...now they want the $$$ back from the 29862 AND29863!!! :mad: Has anyone had this problem before? And what did you do to fight it? Empire is the ins.

Any thoughts/suggestions is always appreciated!
 
I do have a Dr who does these procedures also. I have not billed the 29863 in addition to the 29862 and 29999 which we use for Arthroscopic Labral repair, Acetabuloplasty and Femoral Osteochondroplasty ( depending on which procedure the surgeon does). I always have to appeal the 29999 and send in the Op notes, sometimes the insurance pays and sometimes they do not. We have had a lot of success recently with our appeals of this.
 
Just out of curiousity, what are you charging for these procedures? One of our physicians is doing these same 3 procedures, sometimes all together, and we are having a difficulty setting a legitimate price!
 
Sorry it took me so long to get back to you:

We base the Acetabular Labral Repair on the 29806

The Acetabuloplasty on the 29826

And the Femoral Osteochondroplasty on 27179

That is how I set my fees for these procedures is compare them to a similar procedure which my surgeon helped me do.
 
Arthroscopy hip with labrectomy

Hip arthroscopies are new to us. The first time the docs did a hip scope they used in their op description, excision of labrum and now they are using labrectomy. Is it still 29862?

Can you bill 29862 with 29863?

You guys are great!!!
 
I would say it all depends on what his OP reports describes. I checked the edits and 29862 and 29863 are not bundled.
 
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