McKesson Edits?

kellz0913

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25
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Bensenville, IL
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Has anyone heard of these? Does anyone know how to go about appealing an insurance company who uses these? I've sent in valid info about CPT code 29823 not being bundled with 29824 but every time they come back and say "Per McKesson edits, its inclusive"???
 

iowagirl77

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Cedar Rapids, IA
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29823 should only be billed with 29824 if the debridement is done in a separate area of the shoulder than the other procedures. If the documentation supports 29823, I'd try to appeal with records and state that it was done in separate areas.
 

Henson65

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Has anyone heard of these? Does anyone know how to go about appealing an insurance company who uses these? I've sent in valid info about CPT code 29823 not being bundled with 29824 but every time they come back and say "Per McKesson edits, its inclusive"???
The McKesson edits are unbelievable, to say the least. They bundle codes together that are not bundled per NCCI edits and we are constantly fighting with mainly Blue Cross due to them following the edits. It is a nightmare to say the least and they never care to hear about the NCCI edits/Medicare or anything other than what McKesson says are bundled codes....It seems that more and more insurance companies are beginning to follow the same edits which will only cause an even bigger migraine because Medicare has always been the gold standard but it seems commercial carriers like McKesson better. All I can say is GOOD LUCK
 

kellz0913

Networker
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Location
Bensenville, IL
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The McKesson edits are unbelievable, to say the least. They bundle codes together that are not bundled per NCCI edits and we are constantly fighting with mainly Blue Cross due to them following the edits. It is a nightmare to say the least and they never care to hear about the NCCI edits/Medicare or anything other than what McKesson says are bundled codes....It seems that more and more insurance companies are beginning to follow the same edits which will only cause an even bigger migraine because Medicare has always been the gold standard but it seems commercial carriers like McKesson better. All I can say is GOOD LUCK
Yes nothing is working, And showing them AAOS edits or NCCI edits is like a sinking ship. Thanks so much.
 
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