Wiki LCD L33456 Total Joint Arthroplasty - Incorrect Payments or Denials

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PALMETTO GBA DAILY NEWSLETTER FROM 9/23/16

LCD L33456 Total Joint Arthroplasty - Incorrect Payments or Denials


Issue:
An issue was identified in the Multi Carrier System (MCS) for claims processed for CPT codes outlined in LCD L33456 (27130, 27132, 27134, 27137, 27138, 27445, 27447, 27486 and 27487). Claims processed from September 6 through September 15, 2016, with dates of service June 16, 2016, through September 15, 2016, may have been incorrectly paid or denied. A workaround was implemented on Thursday Sept 15 to correct the problem.

Provider Action:
No provider action is necessary. Affected claims will be identified and adjusted. This CPIL will be updated once the adjustments have been completed.
 
As of 10/3/16, we have yet to receive any payments for our total hip and knee replacements that were denied in error due to the LCD.
Has anyone else had this problem? Have you received and payments for the denied procedures yet?
 
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