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S2900 denied

  1. Question S2900 denied
    Medical Coding Books
    55866 was paid & s2900 was denied.

    Can 55866 & s2900 be billed together?

  2. Default
    Which carrier. s2900 not valid for Medicare ????

  3. Default
    Quote Originally Posted by bill2doc View Post
    Which carrier. S2900 not valid for Medicare ????
    It doesn't say what carrier, but it is commercial.

  4. Default
    We call each insurance company to see if it is payable. So far, none are paying this code.

  5. Default
    Per Ingenix:

    The S codes are used by the Blue Cross/Blue Shield Association (BCBSA) and the Health Insurance Association of America (HIAA) to report drugs, services, and supplies for which there are no national codes but for which codes are needed by the private sector to implement policies, programs, or claims processing. They are for the purpose of meeting the particular needs of the private sector. These codes are also used by the Medicaid program, but they are not payable by Medicare.

    So now what?

  6. #6
    55866 includes robotic assistance so you cannot bill for it separately. That is one of the changes that occurred at the beginning of this year. It's included in the description of 55866 in the CPT.

  7. Default
    Thank you!

  8. #8
    I found this info relating to the S2900 (i was trying to find info on robotic assisted laparoscopic cystectomy)

    In 2007, after two years of examination, the AMA determined that there was no need for a new CPT or unique modifier for surgical procedures completed with robotic assistance. As a result, the majority of leading payers, such as Medicare, CIGNA, United Healthcare and most Blue Cross/BlueShield plans, consider robotic assistance incidental to the primary surgical procedure and not separately billable. S2900 is a Level II HCPCS code issued by a local carrier in 2004, before theAMA's 2007 decision. It is payable at the carrier's discretion. Surgical procedures completed with robotic assistance should be consistent with existing payer policies for advanced laparoscopic surgery and current payer contract rates for the primary surgical procedure.

    This is where I got it

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