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Thread: Medicare Recoup.

  1. #1
    Join Date
    Apr 2007
    Concord NC

    Default Medicare Recoup.

    AAPC: Back to School
    I have a question regarding Medicare take backs. We had money taken back because a Pathologist was used on one block of our Mohs and they billed for a global procedure it seems. A reconsideration was already denied. Since the Pathologists was used do we have leg to stand on even though it was only one block? These are older dates of service. Can you appeal a new code to the C2? I have never heard of that being done like a corrected claim.

    Thank you in advance for you help with this matter.


  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    there is no way you can bill a mohs if even one block was sent out to a different pathologist. If you are going to change the codes you would not appeal you would do it as a corrected claim.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Join Date
    Apr 2007
    Concord NC


    I agree reconsideration were already sent and denied. The date range is 2009 to 2011 so resubmission would be denied as stale date on the older dates. I sent you a message earlier today regarding the issue here.

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