Multiple Claims in 1 Day

lnld9

New
Local Chapter Officer
Messages
6
Best answers
0
I'm taking over the Compliance portion for a small Dermatology Office. Right now the provider will submit MOHs on one claim, but then submit the biopsy on a different claim that gets signed off a week or more later. And another provider will chart and bill for the closures. This is causing multiple claims to be sent out for the same day, same provider, and it's causing denials usually for bundling. I know the provider needs to put the MOHs and the biopsy on the same claim as it's all the same day and same office, but I was wondering if there was some documentation as this has been the way they have been billing for years.
Thanks!
 
Messages
157
Location
Coeur d'Alene, Idaho
Best answers
0
I would recommend referencing the NCCI manual which can be accessed from this link:
https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html
CPT also has a good description prefacing the Mohs codes. I would also recommend checking to see if your MAC has an LCD that discusses Mohs surgery. The LCD for Novitas can be found at this link:
https://www.cms.gov/medicare-coverage-database/details/article-details.aspx?articleId=53883&ver=7&LCDId=34961&name=331*1&UpdatePeriod=830&bc=AAAAEAAAAAAA&
 

lnld9

New
Local Chapter Officer
Messages
6
Best answers
0
I would recommend referencing the NCCI manual which can be accessed from this link:
https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html
CPT also has a good description prefacing the Mohs codes. I would also recommend checking to see if your MAC has an LCD that discusses Mohs surgery. The LCD for Novitas can be found at this link:
https://www.cms.gov/medicare-coverage-database/details/article-details.aspx?articleId=53883&ver=7&LCDId=34961&name=331*1&UpdatePeriod=830&bc=AAAAEAAAAAAA&
Thank you!
 
Top