tgutierrez
Networker
I hope someone has an answer for me. This is a new one for me.
I have a patient that had multiple procedures performed by two different surgeons. Not co-surgeons, not assist. All procedures the surgeon's did were not related to each other.
I have found in the Medicare billing guidelines that the physicians will be reimbursed as normal (100-50-50...). The will be reduced per multiple procedures only if they themself performed multiple procedures.
But what about the facility? The claims went out seperately (our software system would not allow to bill both physicians' charges on the same claim) and on the first claim they processed they paid as normal: 100%, 50%, etc. but on the second claim they reduced the primary procedure to 57% and the remainder at 50%.
I've looked all over the internet and Medicare's website and can not find any literature for this.
Does anyone have any info on surgical situations like this? Is this correct reimbursement? Where can I find some answers?
I would really appreciate any information any one can offer.
Thanks fellow coders!!!!
I have a patient that had multiple procedures performed by two different surgeons. Not co-surgeons, not assist. All procedures the surgeon's did were not related to each other.
I have found in the Medicare billing guidelines that the physicians will be reimbursed as normal (100-50-50...). The will be reduced per multiple procedures only if they themself performed multiple procedures.
But what about the facility? The claims went out seperately (our software system would not allow to bill both physicians' charges on the same claim) and on the first claim they processed they paid as normal: 100%, 50%, etc. but on the second claim they reduced the primary procedure to 57% and the remainder at 50%.
I've looked all over the internet and Medicare's website and can not find any literature for this.
Does anyone have any info on surgical situations like this? Is this correct reimbursement? Where can I find some answers?
I would really appreciate any information any one can offer.
Thanks fellow coders!!!!