deborahcook4040

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We bill to FCSO medicare contractor for global services for pacemaker interrogation and programming. We own all the equipment we use, and we perform interrogation and programming services in our office (POS 11). Our corporate office is instructing us that:

A: We are not allowed to bill globally for either interrogation or programming if the PC and TC are rendered on different dates (he generally reads them next day unless the patient is having issues). CMS says they leave that up to the contractor to decide, but i can't find any advice from FCSO. They're basing their instructions to bill 2 claims (PC and TC) on advice from another contractor. Does anyone know what FCSO says to do? We have always billed globally on the date the TC service was rendered, and other local cardiology coders I've spoken with bill the PC on the date the TC was rendered.

B: When we do our interrogations (so i'm told), we input a threshold into the device, interrogate it, and then reset the device to it's original specifications. We bill this as interrogation; corporate is instructing us that if any thresholds are input, we should bill as programming, even if no permanent changes are made. Is this correct? In the past we have only billed programming if we saved the changes.

I would greatly appreciate direction to FCSO, CMS or other documentation, whether to back up our current process or definitively tell us we're doing it wrong.

Thanks,

Debby
 
Recently on a Medaxiom webinar, they were saying that "iterative adjustments" would support billing the Reprogramming code range. I found a link (albeit from 2012) to an AAPC pdf that has this info also. https://www.aapc.com/localchaptereventagendas/ebfa8d31-e7f1-4e53-a730-d0289a97aafe.pdf I just Googled "iterative programming a pacemaker" and got several hits. I would be interested in what the documentation would look like to report these.

I do not know about anything about FCSO. Sorry on that one.

Hope that helps some.
 
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