gnhobbs@ppmh.org
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Confusion of the LCD L32112 and L32116
we have claims denying for patients who have bilateral injections/facets/MBBs/RF's because for each side they have to have the same # of injections and that puts them over the limit on the # of injections they can have per year. We have them sign an ABN, but still, is there anyway to fight/clarify this because the LCD's state "per region".
Also, L32112 states "injection sessions per region"
and L32116 states " facet injection sessions"
so, does that mean they can have 6 regular injections AND 6 facet/rf injections?
of course, can't get any clarification from Medicare reps..
thanks in advance for any advice/help
we have claims denying for patients who have bilateral injections/facets/MBBs/RF's because for each side they have to have the same # of injections and that puts them over the limit on the # of injections they can have per year. We have them sign an ABN, but still, is there anyway to fight/clarify this because the LCD's state "per region".
Also, L32112 states "injection sessions per region"
and L32116 states " facet injection sessions"
so, does that mean they can have 6 regular injections AND 6 facet/rf injections?
of course, can't get any clarification from Medicare reps..
thanks in advance for any advice/help