bruharocks
New
Has anyone else run into this problem with NGS Medicare? I am doing the anesthesia billing for a group, and the surgeon is billing 37225, in the office setting, place of service 11. We are billing as place of service 11 as well, with code 01924-AA, and are receiving the denial;
"treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Note: refer to the 835 healthcare policy identification segment (loop 2110 services payment information ref), if present."
I cannot find any information on why the code is being denied. I even did a first level appeal showing the surgeon's claim was processed and paid in the office setting, and also attached the office accreditation, but that too was denied. I have the option of an external second level appeal, but not sure what else to send.
We are also having this same problem, only with NGS Medicare, when billing the anesthesia for TEE in the office setting.
Can anyone help? This group says they have been paid before by Medicare in the office setting, so I don't see why these claims are all being denied..
Thank you to anyone who has any insight, it will be greatly appreciated.
"treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service. Note: refer to the 835 healthcare policy identification segment (loop 2110 services payment information ref), if present."
I cannot find any information on why the code is being denied. I even did a first level appeal showing the surgeon's claim was processed and paid in the office setting, and also attached the office accreditation, but that too was denied. I have the option of an external second level appeal, but not sure what else to send.
We are also having this same problem, only with NGS Medicare, when billing the anesthesia for TEE in the office setting.
Can anyone help? This group says they have been paid before by Medicare in the office setting, so I don't see why these claims are all being denied..
Thank you to anyone who has any insight, it will be greatly appreciated.