Tonyj
True Blue
Medicare is denying photopheresis (extracorporeal) 36522 due to GVHD when used with complication code 996.88 (complication of transplanted stem cell from peripheral blood; umbilical cord). NCD had approved the code (996.88) in September of 2012 then rescinded the approval a couple of weeks later stating investigational?? MCR will pay for GVHD with 996.85 (complication of transplanted bone marrow/stem cell).
My question; How can I bill a cancer pt that has developed GVHD (279.5x) after transplant with complication code (996.88 peripheral blood stem cell) if the stem cell was harvested peripherally instead of via the bone marrow? Do I continue to code the complication using 996.85 with GVHD in order to get paid?
My question; How can I bill a cancer pt that has developed GVHD (279.5x) after transplant with complication code (996.88 peripheral blood stem cell) if the stem cell was harvested peripherally instead of via the bone marrow? Do I continue to code the complication using 996.85 with GVHD in order to get paid?