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Wiki Method II Claim- Low Cost Skin Product

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caitlyn8390

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Trying to submit claim to Noridian for low cost skin application on 851 bill type. Q4117 billed with C5271, C5272 for the facility charge. Physician charge billed with 15271. Noridian sending back stating we have to add a high cost skin product to go with the 15271. I have tried and tried and tried to talk to Noridian call center about this and their feedback is to either add the PC indicator, bill the C5271 for the physician charge or add a high cost skin product. I cannot add high cost product as we didn't provide and I informed them that was fraud. C527x is not found on the Physician's Fee Schedule so that option is out. PC indicator not applicable per the Physician's Fee Schedule. I have tried to escalate to their medical director but so far everyone is telling me the same thing. Anyone out there submit low cost skin product claims via Method II?? I get why it's hitting the edit but I am convinced it's not taking into account the profee revenue code/PFS. Happy to be proven wrong.
 
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