kbordner2
New
Is anyone having issues with reimbursement for long term unmonitored wo video codes from Medicare? For example, a patient starts recording at 9am on day 1 and ends at 9am on day 4, we bill 95700 x1, 95708 x3, 95705 x1 and 95723x 1. We never get reimbursed for all codes/ all days. Medicare denies for Medical necessity, however I can not find where on the LCD we are not meeting unless it is for the section stating 'Medicare would not expect to see more than 3 services (3 of a single or 3 of any combination of services) billed in most circumstances within a 1-year period. ICD-10s are compliant with LCD and we always do a routine EEG first. Medicare may reimburse for day 1 95700 and 95708 and day 2 95708 and the PC code 95723 on the last day, however they do not reimburse for day 3 95708 and day 4 95705. Are they counting each TC code as a service as well as the PC code? Any insight is greatly appreciated.