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Thread: Billing Category III codes

  1. #1
    Join Date
    Apr 2007

    Default Billing Category III codes

    AAPC: Back to School
    Can anyone tells us how you set your fees for those Category III codes that have not been give reimbursement rates by CMS? In particular the codes 0114T, 0145T, 0146T etc.

    Last edited by elohrenz; 08-28-2007 at 07:50 AM.

  2. #2
    Join Date
    Apr 2007
    Seacoast- Dover New Hampshire

    Default Cat III

    They are for reporting only. No RVU'S yet...
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. #3
    Join Date
    Apr 2007
    Lafayette, LA


    I'm not sure how our doc's went about pricing for the "T" codes. But we bill 1999.00 for the 0146T & 0147T.

  4. #4

    Unhappy Category III

    I have a question. In the practice that I work, they are not coding 0146T etc, because is not payable or because the Insurance company will not have the code on their system foe authorization, therefore my office is billing CTA non coronay. Is this is correct? My undertanding is not a code for the CTA coronary we are to used cat III codes? Please advise

  5. #5
    Join Date
    Apr 2007
    Lafayette, LA


    We have had a lot of trouble with most major managed care's paying for the "T" codes. I'm sure you know BCBS and Aetna will not pay no matter what you code or send. Most of the CT"s that we get paid on are from "off the wall insurance companies". One of the major companies we were having trouble with was UHC. We were billing 0147T and getting denials requesting med. rec's. Once sent they would deny again stating "experimental". We were able to talk to one of the big wheel's over there and were told to bill 0146T and send with report and LMN. Now UHC is paying on 85+% of our CT's.

  6. #6

    Default Category III Codes

    In houston we have to same difficulty with billing and reimbursement for Category III Codes.

    Are other Cardiology Practices billing for 0126T and how much are you billing for this service. TrailBlazer's list this service as non covered.

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