Melissa*Ever*Evolving
Networker
Hi!
We have been receiving payment for TAP blocks without problems when Anesthesiologist provided for Postoperative Pain Management.
We recently have seen denials from Novitas Solutions (for MD claim) denying this because it was provided at an ASC and 64486 and 64488 have ASC status of N1.
Can we fight this? N1: Packaged Item/Service: No separate payment made. (for the ASC, not the MD)
My arguement is that:
This is inherently paid as a bundled payment to the ASC. This did not mean that this procedure cannot be performed at an ASC. (right?)
The Anesthesia Provider should be compensated for this additional procedure as it is not a bundled service when provided for post operative pain management.
What are your thoughts?
If there is anything I am missing from CMS manual that explains this stance, please flag to me.
Your help is very much appreciated!
Thank you!
~Melissa, CPC
We have been receiving payment for TAP blocks without problems when Anesthesiologist provided for Postoperative Pain Management.
We recently have seen denials from Novitas Solutions (for MD claim) denying this because it was provided at an ASC and 64486 and 64488 have ASC status of N1.
Can we fight this? N1: Packaged Item/Service: No separate payment made. (for the ASC, not the MD)
My arguement is that:
This is inherently paid as a bundled payment to the ASC. This did not mean that this procedure cannot be performed at an ASC. (right?)
The Anesthesia Provider should be compensated for this additional procedure as it is not a bundled service when provided for post operative pain management.
What are your thoughts?
If there is anything I am missing from CMS manual that explains this stance, please flag to me.
Your help is very much appreciated!
Thank you!
~Melissa, CPC