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Medicare denial on S2083

  1. #1
    Harrisburg, PA
    Angry Medicare denial on S2083
    Medical Coding Books
    I am currently working for a small office in Harrisburg, PA and we have started receiving denials for the Lap Band adjustment code (S2083). We called Medicare and they told us that they are no longer accepting this code. Is there anyone out there that is also having this problem and has found a way to get the Lap Band Adjustments paid.

  2. #2
    S codes cannot be billed to Medicare. If you look at the coding instructions at the beginning of the S codes in the HCPCS book it states that they are Temporary National Codes (Non-Medicare)
    We have had to bill 43999 with a note on the appropriate area of the HCFA describing the procedure and so far we are receiving pymt from several different Medicare carriers but you may have to submit a few different UPC codes to Medicare until you find the code that your carrier will reimburse.
    But believe me, we all are feeling your pain!!!!!
    Anita W, CIRCC, RCC, CPMA, CPC

  3. #3
    Harrisburg, PA
    Default Upc?
    What is a UPC? And where do we find it?

  4. #4
    Unlisted Procedure Code, these are the codes at the end of the code sections in CPT they end with 99.

    Laura, CPC

  5. #5
    We are billing the 43999 code to Medicare for the adjustment. I am struggling with the correct ICD-9 code to bill.

    My coder insists on using the V45.86 Bariatric Surgery Status as the one and only code. I know this code can not be used as primary.

    I say we should use the reason for the band 278.01 (morbid obesity) as the primary code with the V45.86 code secondary.

    I just read somewhere that we should be using 799.9 with the V45.86 code second.

    I called Realize reimb line and they instructed me to use the reaon for the surgery with the bariatric surgery status second.

    Any insight?
    Christina Lee Wagner, CPC, CPC-H

  6. Default
    For lap band adjustments to medicare i bill 90799

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