Wiki Medicare and 15100 and 15101

[livingitupinok]

I am working on coding for an ASC center. I have billed 15100, 15101 and 15002. Medicare is not paying the base code 15100. Can someone give me insight on this. I am new to coding/billing for Medicare. I have asked another coder who says that Medicare doesnt pay the base code sometimes. HELP

 

[mitchellde]

I do not feel it is correct to say that they routinely do not pay the base code. It may have to do with the way you listed them on the claim and in conjunction with what ICD-9 Code. Can post more detail?

 

[livingitupinok]

We get our ASC coding from someone off site, then I try to fox it when it rejects
She coded it as follows: All using the ICD-9 code 709.2
15100, 15101, 15002-51
15100, 15101-51
they pd all but the 15100.

they repaired two seperate areas

 

[mitchellde]

We get our ASC coding from someone off site, then I try to fox it when it rejects
She coded it as follows: All using the ICD-9 code 709.2
15100, 15101, 15002-51
15100, 15101-51
they pd all but the 15100.

they repaired two seperate areas

So these codes were all billed on the same claim? as in you have 15100 billed twicw and 15101 billed twice and 15002 billed once? Also the dx code for a scar, what is this scar from? is it due to a burn or is it keloids from a laceration? If so there needs to be another dx code for this such as a 905 code for late effect. Also the prep of of the surgical site does not match to the graft code, meaning you prepped 100 sq cm but then billed in excess of 100 sq cm of grafting, also if two separate areas are repaired you do not bill separate with these codes you add the entire amount together. More info is definitely needed but I feel this was not coded appropriately at all.

 

[livingitupinok]

Thank you neither did I, but I wanted to make sure of this since I dont do ASC before I went to my supervisor.

Have a great day