The CPT 77336 and 77370 getting denied in POS 22 and need to bill only the professional service but the service is applicable for only TC. Kindly advice how to bill these CPT in which POS this service is billable.
The TC of any services performed in a hospital would need to be billed by the facility on a UB-92 claim. Physicians are not reimbursed for technical services in POS 22 because it’s the responsibility of the hospital to cover those costs. The physician may only bill these codes when the services are performed in their own offices.The CPT 77336 and 77370 getting denied in POS 22 and need to bill only the professional service but the service is applicable for only TC. Kindly advice how to bill these CPT in which POS this service is billable.
Thank you so much ! Mostly blue cross and blue shield denied CPT 77336 and 77370 in POS 22@thomas7331 is correct that there is not a professional component for these codes. If your POS is 22, the physicist's charges would go on the facility bill. The physician would not bill for the physics services.
I code and bill for Radiation Oncology professional fees, and I also work closely with my facility counterparts who code/bill the technical components.
I asked what payor was giving the denial for POS 22 because Aetna Medicare has been having strange denials pop up recently. I'm in a radiation oncology coding and billing discussion group, and many people are having different issues with Aetna Medicare. Some of them have been told by provider relations that systems have been updated to resolve some of those issues and claims will be reprocessed - we'll see. I'm keeping a close eye on my Aetna Medicare in the meantime.
The issue that I personally have been encountering is CT guidance codes denying invalid POS 22. Which is, of course, ridiculous. POS 22 is the most typical setting for performing radiation oncology services!
If your issue is with a different payor, it might help if you share what payor. Someone else might be aware of additional issues.
its Blue cross and blue shied..Which payor is giving that denial?
Aetna was giving me those denials, and I even appealed. Was told it was a no go because Aetna's policy doesn't allow for the guidance with certain modalities. I don't have access to the denial anymore, but if you found a way to counter these I'd be interested in hearing about it.@thomas7331 is correct that there is not a professional component for these codes. If your POS is 22, the physicist's charges would go on the facility bill. The physician would not bill for the physics services.
I code and bill for Radiation Oncology professional fees, and I also work closely with my facility counterparts who code/bill the technical components.
I asked what payor was giving the denial for POS 22 because Aetna Medicare has been having strange denials pop up recently. I'm in a radiation oncology coding and billing discussion group, and many people are having different issues with Aetna Medicare. Some of them have been told by provider relations that systems have been updated to resolve some of those issues and claims will be reprocessed - we'll see. I'm keeping a close eye on my Aetna Medicare in the meantime.
The issue that I personally have been encountering is CT guidance codes denying invalid POS 22. Which is, of course, ridiculous. POS 22 is the most typical setting for performing radiation oncology services!
If your issue is with a different payor, it might help if you share what payor. Someone else might be aware of additional issues.