Results 1 to 2 of 2


  1. #1
    Question 65780
    Medical Coding Books
    Does anyone know if this procedure can be paid in the office???? I have a denial from Medicare saying this is not payable in the office setting. Our coding program is showing an allowable for the facility and non facility but the representative says this is not payable. When asked what LCD or policy name this information is located, they could not give me an answer and was just told we could appeal it. Anyone have any guidance on this. I have researched this CPT and I find not information that this procedure cannot be done in the office.


  2. #2
    Thumbs up
    Your coding program doesn't pay your claims. What does your LCD say for this service and your provider type. Remember, payor guidelines can trump regular CPT rules. As long as its spelled out, proceed.

    CMS will NEVER provide advice, LCD guidance or look-up. Go to your contract carrier for your region, search the code and/or provider specialty and read through. Have a cup of tea or coffee, some searches take a while.
    [COLOR="Blue"]Kandy Morris CCS, CCS-P, CPC, CPB, CPC-I, CPMA, CEMC, CPOC
    AHIMA-approved ICD-10CM/PCS Trainer & Ambassador
    AAPC PMCC Approved Instructor

Similar Threads

  1. 65780 & 65400
    By MYAEKEL in forum Ophthalmology/Optometry
    Replies: 0
    Last Post: 10-08-2010, 10:46 AM
  2. 65780 or 65426
    By codedog in forum Ophthalmology/Optometry
    Replies: 1
    Last Post: 04-29-2010, 08:37 AM
  3. Pterygiums removals 65780
    By tazmania in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 12-29-2009, 07:20 AM
  4. V2790 not paid with 65426 & 65780
    By MelissaCCS-P in forum Outpatient Facilities
    Replies: 2
    Last Post: 05-14-2009, 12:56 PM
  5. V2790 not paid with 65780 or 65426??? Need help
    By MelissaCCS-P in forum ENT/Otolaryngology
    Replies: 3
    Last Post: 05-12-2009, 12:25 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.