Wiki Screws and implants

[ShauntaEskridge]

I am currently billing L8641 L8642 L8658 L8659 on my professional claims to Medicare very rarely they pay and sometimes it’s denied with CO -16 claim service lacks information or has submission/billing errors. How do I get Medicare to pay on these codes as they are not denied all the time. Any and all comments are welcome. Thanks

 

[SharonCollachi]

Wouldn't these be billable by the ASC or hospital, and not the physician?

 

[ShauntaEskridge]

The physician is the purchaser

 

[SharonCollachi]

That doesn't mean he should be, however. Is this being done in an ASC, a hospital, the office...?

 

[ShauntaEskridge]

That doesn't mean he should be, however. Is this being done in an ASC, a hospital, the office...?

This is being done in an ASC. However the ASC is not accredited with Medicare. It’s only JCAHO certified.

Quote

 

[SharonCollachi]

The ASC is responsible for supplies. If they are not accredited with Medicare, then you shouldn't be doing procedures there for Medicare patients.

In any case, the ASC is responsible. You may be looking at recoupment for what has already been paid to you, at some point in the future.

 

[ShauntaEskridge]

The ASC is responsible for supplies. If they are not accredited with Medicare, then you shouldn't be doing procedures there for Medicare patients.

In any case, the ASC is responsible. You may be looking at recoupment for what has already been paid to you, at some point in the future.

So the billing for Medicare patients should go out as an in office procedure correct? . I’m beginning to notice a lot of questionable action by this office in regards to billing. This is very insightful it just confirms everything I was already thinking /aware of thank you.

 

[SharonCollachi]

If the procedure was not done in the office, you cannot bill it as if it were done in the office.