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Medicare remit advice

  1. Default Medicare remit advice
    Medical Coding Books
    Does anyone know what the MCR remit advice adjustment code CO-58 really means? We are getting these adjustments on colonoscopy/endoscopy procedures but are getting the correct payment for facility place of service. Medicare has not been forthcoming with any information. Thanks!!

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    Quote Originally Posted by apower66 View Post
    Does anyone know what the MCR remit advice adjustment code CO-58 really means? We are getting these adjustments on colonoscopy/endoscopy procedures but are getting the correct payment for facility place of service. Medicare has not been forthcoming with any information. Thanks!!
    so who are you billing for the physician or the facility? The last page of your remit will tell you what the descriptors are for co-58. to me it appears to be that you are using the wrong place of service code for the physician, but that is just a guess.

    who are you billing for and what type of facility is the procedure being done? I do a lot of endoscopy billing for a facility so let me know.

    Caprice-CPC

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    Physician billing...he does not have an ASC so colon/egd procedures are done outpatient at a local hospital. Therefore POS billed is 22. I heard that this CO58 is associated with many adjustment reasons but MCR will not answer specifics. I was also told it might be the adjustment reason due to the fact the doctor is not getting the full reimbursement but rather the facility fee due to 22 POS vs 11?

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    Did they not include a remit code (usually an M or N code)? Claims that have a denial code usually include some type of remit code on the left side that usually make more sense than the OA and CO codes.

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    No, it is just an adjustment code...no further remark codes. The claims are paying correctly per the facility fee schedule but it is frustrating not to be able to get any specifics!!

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