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Corneal Transplants

  1. #1
    Default Corneal Transplants
    Exam Training Packages
    Has anyone had success in Medicare paying for Corneal Transplants?

    Thanks
    Sincerely,

    Kristie Stokes, CPC, CPMA, CCS, CMDP, ICDCT-CM

    AAPCCA Board of Directors 2014-2017
    Region 1 - Northeast
    Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York

    Today, give a stranger one of your smiles. It might be the only sunshine they see all day.

  2. #2
    Default
    Yes...We get paid for the cornea transplant...we use CPT V2785...When we bill the claim we attach the invoice as well.
    NoRaX

  3. #3
    Default
    I did that also.. My codes were 65756, 65870, 65865, and V2785.. all of which were denied for treatment has not been deemed 'proven to be effective' by the payer??
    Sincerely,

    Kristie Stokes, CPC, CPMA, CCS, CMDP, ICDCT-CM

    AAPCCA Board of Directors 2014-2017
    Region 1 - Northeast
    Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York

    Today, give a stranger one of your smiles. It might be the only sunshine they see all day.

  4. #4
    Default
    If all of them were denied...I would do a Medicare Review...I get paid without denials for those codes that you billed...are you using the 59 modifier too?
    NoRaX

  5. #5
    Default
    In Pennsylvania Medicare has been paying for corneal transplants for years. However, Medicare has changed how they are submitted. They no longer require a copy of the invoice; this information is included when you bill electronically. Check with your electronic carrier on how to do this; I used Advantx and it was the addition of one line entry while entering the keratoplasty code. If you are not billing the way Medicare requires, it will deny. I hope this helps.
    Anastasia, CPC, CASCC, COBGC

  6. #6
    Default
    Anastasia,

    I use Advantx.. can you tell me what to use on the code to send it electronically (or email me..kstokes@timoniumsurg.com). Or is that something I need to call Medicare on?

    Thanks
    Sincerely,

    Kristie Stokes, CPC, CPMA, CCS, CMDP, ICDCT-CM

    AAPCCA Board of Directors 2014-2017
    Region 1 - Northeast
    Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York

    Today, give a stranger one of your smiles. It might be the only sunshine they see all day.

  7. #7
    Red face
    Kristie
    Don't call Medicare--they won't help. Call Advantx. After you enter the keratoplasty code you have to go to the additional info tab and add Medicare-specific wording on line 2 that includes the amount of the cornea. Advantx will definitely help. I'm sorry I don't have the exact wording to give you (I'm not at work right now) but Advantx gave it to me. Let me know how you make out.
    Anastasia, CPC, CASCC, COBGC

  8. #8
    Default
    Thank you, I just saw your post... I'll check into it. If you can remember what the verbage is, please let me know ....
    Sincerely,

    Kristie Stokes, CPC, CPMA, CCS, CMDP, ICDCT-CM

    AAPCCA Board of Directors 2014-2017
    Region 1 - Northeast
    Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York

    Today, give a stranger one of your smiles. It might be the only sunshine they see all day.

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