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Code 11201 and Medically Unlikely Edits?

  1. Default Code 11201 and Medically Unlikely Edits?
    Medical Coding Books
    Does anyone have any additional information on this? I found that CMS' rationale for setting the units to '0' as "Clinical: CMS Workgroup," but I haven't been able to find anything else to support why the unit threshold on the practitioner table for this most recent quarter. Any documentation or source info would be great. Thanks!

  2. Default
    Are you billing a 11200 for the first 15 and then 11201 for each additional ten? I am confused by this.

  3. Default
    Quote Originally Posted by sarahandross@rocketmail.com View Post
    Are you billing a 11200 for the first 15 and then 11201 for each additional ten? I am confused by this.
    I am not billing it at all. I work for a payer and when CMS publishes their quarterly tables, we research codes that have units set to '0.' I was looking for clarification on CMS' rationale of "Clinical: CMS Workgroup."

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