Hello,
I'm new to billing anesthesia. I have an Medicare HMO insurance carrier that is denying our anesthesiologist claim because the surgeon is billing a different surgery CPT than what we are billing. Per the operative report from the surgeon, the CPT should be 52234; however, the surgeon billed 52204. We did the crosswalk for 52234, not for 52204. Should we change our code to match the surgeons code or have the surgeon change his code? Also, I've been trying to find something on the CMS website that states we have to bill the same code as the surgeon, but cannot find anything. Can someone direct me?
Thanks
Michele CPC
I'm new to billing anesthesia. I have an Medicare HMO insurance carrier that is denying our anesthesiologist claim because the surgeon is billing a different surgery CPT than what we are billing. Per the operative report from the surgeon, the CPT should be 52234; however, the surgeon billed 52204. We did the crosswalk for 52234, not for 52204. Should we change our code to match the surgeons code or have the surgeon change his code? Also, I've been trying to find something on the CMS website that states we have to bill the same code as the surgeon, but cannot find anything. Can someone direct me?
Thanks
Michele CPC