• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

Mckesson Edits

denamfailla

Contributor
Messages
24
Best answers
0
does anyone know that rules for the McKesson Edits? and/or how they are different than the CCI edits? Specifically, I work for a radiologist company and we only do the reading for a hospital and codes 76856 76830-59 have been getting rejected. They were always paid up until recently and don't know why. Any info would be much appreciated.

thank you!
-Dena
 

kevbshields

Guest
Messages
1,101
Location
Louisville, KY
Best answers
0
McKessons tends to heavily favor payer ideas of "bundling". Most of its edits are loosely based on CCI, then expanded. As for the logic, sometimes I do not believe there is any to what McKesson insists is an "edit."

Whoever works for this company takes their liberties at doing some heavy personal interpretation and invention on bundling rules--unless things have changed drastically in the past few years.

This doesn't help any, but might help to explain your (and my) confusion. The payers trust these edits way too much, in my opinion.
 

cblack712

Guest
Messages
109
Best answers
0
From the looks of it I am not sure that this one is a McKesson edit, the problem may be that you are using a 59 when it is not required. I have worked radiology for many years and have never had to add a 59 -- at most we have to use a 51 for some payers.
 
Top