Hi, our Medicare carrier is Palmetto (changed this year from Trailblazer) and we are having issues with getting payment on multiple units for IR procedures.
For example, you can have 2 units of 36216 for the left side (one unit for the Int. Carotid and one for the vertebral as they are in seperate vessel/artery families). Med will pay for 1 unit and deny the 2nd. Then on appeal for the 2nd unit deny it as a duplicate.
Anyone else having this issue? Anyone find a resolution to this issue?
As this brings us to our major issue with this in when a spinal angiogram is done. We recently have done one and have 16 units of 36215 to bill (8 on the rt and 8 on the lt). This is just one of the many codes we have for this one procedure we need to bill with multple units with amounts over 4.
Is there anyone else who are doing the spinal angiograms and do you mind sharing if you have had this issue with Medicare and if you have found a resolution to the problem? Any suggestions on how to best bill this out since we know 36215 -rt/lt 16 units is not an option. We are considering trying this break down:
36215 -RT 1 unit
36215 -59/RT 7 units
36215 -59/LT 8 units
Thanks!
For example, you can have 2 units of 36216 for the left side (one unit for the Int. Carotid and one for the vertebral as they are in seperate vessel/artery families). Med will pay for 1 unit and deny the 2nd. Then on appeal for the 2nd unit deny it as a duplicate.
Anyone else having this issue? Anyone find a resolution to this issue?
As this brings us to our major issue with this in when a spinal angiogram is done. We recently have done one and have 16 units of 36215 to bill (8 on the rt and 8 on the lt). This is just one of the many codes we have for this one procedure we need to bill with multple units with amounts over 4.
Is there anyone else who are doing the spinal angiograms and do you mind sharing if you have had this issue with Medicare and if you have found a resolution to the problem? Any suggestions on how to best bill this out since we know 36215 -rt/lt 16 units is not an option. We are considering trying this break down:
36215 -RT 1 unit
36215 -59/RT 7 units
36215 -59/LT 8 units
Thanks!