Results 1 to 4 of 4

36200 denied by Tricare

  1. #1
    Default 36200 denied by Tricare
    Exam Training Packages
    Is anyone having trouble with Tricare denying 36200 as global to 75625 and 75716? They are denying even after we submit the report which clearly documents all codes. Has anyone had any success getting the 36200 paid after Tricare denies it? Thanks!

  2. #2
    Location
    Richardson, TX
    Posts
    822
    Default
    Do you have -59's on the 75716 & 75625? I know with the new rules if they were precviously done you are unable to bill for them unless there is a change in the pt's condition and for some other reasons. Take look at pg 373 in your AMA CPT. They outline the rules.

    That's what comes to mind.
    Julie Graham, BA, CPC, CCC

  3. #3
    Default
    Hi! Thanks for the help, but no intervention was done. The only thing done was diagnostic angiography with documentation of aorta in the report. 36200, 75625, 75716. I am still at a loss, can anyone help? Thanks!

  4. #4
    Location
    Alexandria, LA
    Posts
    518
    Default
    My guess is that when Tricare put in the edits for cath codes with revascularization (372xx) they goofed and included all angiography. You need to appeal (possibly up to at least the 2nd level) to get them to fix this.

Similar Threads

  1. 36221 with 36200?? PLEASE HELP
    By brandyleigh23 in forum Cardiology
    Replies: 2
    Last Post: 10-02-2014, 07:41 AM
  2. 36200
    By amym in forum Cardiology
    Replies: 2
    Last Post: 07-03-2013, 10:47 AM
  3. Injections denied by Tricare
    By dyoungberg in forum Anesthesia
    Replies: 3
    Last Post: 02-23-2013, 08:45 PM
  4. Is it 36200+?
    By amym in forum Cardiology
    Replies: 1
    Last Post: 12-15-2011, 11:17 AM
  5. 36200 +
    By amym in forum Cardiology
    Replies: 0
    Last Post: 07-21-2011, 02:26 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.