20160831 - FREE Code Books with Exam Prep Packages | Learn More

AAPC - August DL Sale: 50% OFF
Results 1 to 5 of 5

Thread: Medicare and 15100 and 15101

  1. #1

    Default Medicare and 15100 and 15101

    AAPC: CPC Promo
    I am working on coding for an ASC center. I have billed 15100, 15101 and 15002. Medicare is not paying the base code 15100. Can someone give me insight on this. I am new to coding/billing for Medicare. I have asked another coder who says that Medicare doesnt pay the base code sometimes. HELP

  2. #2
    Join Date
    Apr 2007
    Location
    Columbia, MO
    Posts
    12,074

    Default

    I do not feel it is correct to say that they routinely do not pay the base code. It may have to do with the way you listed them on the claim and in conjunction with what ICD-9 Code. Can post more detail?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3

    Default

    We get our ASC coding from someone off site, then I try to fox it when it rejects
    She coded it as follows: All using the ICD-9 code 709.2
    15100, 15101, 15002-51
    15100, 15101-51
    they pd all but the 15100.

    they repaired two seperate areas

  4. #4
    Join Date
    Apr 2007
    Location
    Columbia, MO
    Posts
    12,074

    Default

    Quote Originally Posted by livingitupinok View Post
    We get our ASC coding from someone off site, then I try to fox it when it rejects
    She coded it as follows: All using the ICD-9 code 709.2
    15100, 15101, 15002-51
    15100, 15101-51
    they pd all but the 15100.

    they repaired two seperate areas
    So these codes were all billed on the same claim? as in you have 15100 billed twicw and 15101 billed twice and 15002 billed once? Also the dx code for a scar, what is this scar from? is it due to a burn or is it keloids from a laceration? If so there needs to be another dx code for this such as a 905 code for late effect. Also the prep of of the surgical site does not match to the graft code, meaning you prepped 100 sq cm but then billed in excess of 100 sq cm of grafting, also if two separate areas are repaired you do not bill separate with these codes you add the entire amount together. More info is definitely needed but I feel this was not coded appropriately at all.
    Last edited by mitchellde; 10-09-2013 at 01:08 PM.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5

    Default

    Thank you neither did I, but I wanted to make sure of this since I dont do ASC before I went to my supervisor.

    Have a great day

Similar Threads

  1. Replies: 1
    Last Post: 05-17-2012, 12:27 PM
  2. Add or multiple 11043 & 15100?
    By jdemar in forum Plastic Surgery
    Replies: 0
    Last Post: 07-15-2011, 08:08 AM
  3. Replies: 1
    Last Post: 01-18-2011, 11:54 AM

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.