bethb
Guru
Our general surgeon billed a 62223-62, co-surgeon, with a place of service 22, outpatient hospital. We received a denial from the insurance carrier (Insurance carrier is a commercial plan, not Medicare or Medicare Part C) advising the procedure is not usually "in" the place of service reported, per CMS guidelines.
I checked into the code and found it has an ASC payment indicator of C5-inpatient procedures.
Can anyone help me with this question--Is payment of services under the Medicare Physician Fee Schedule indicative of payment indicators for ASC / OPPS? i.e. the denial we received for professional services (62223) is being based on Ambulatory Surgery Center payment indicator rules.
Thanks!
I checked into the code and found it has an ASC payment indicator of C5-inpatient procedures.
Can anyone help me with this question--Is payment of services under the Medicare Physician Fee Schedule indicative of payment indicators for ASC / OPPS? i.e. the denial we received for professional services (62223) is being based on Ambulatory Surgery Center payment indicator rules.
Thanks!