Medical Billing Forum

Payments => Insurance Payments => : jenhigh October 26, 2015, 12:39:35 PM

: Payment Groupers
: jenhigh October 26, 2015, 12:39:35 PM

I am questioning payments on RFA codes 64633 thru 64636 for an ASC facility claim. What reimbursement group should they be paid from? Some insurances are paying for grouper 1 and others grouper 2.

: Re: Payment Groupers
: pankaj October 26, 2015, 03:00:48 PM

According me they should pay from grouper 1 and if any insurance is paying from grouper 2 you must call and try to reprocess the claim with correct grouper 1 because rates are higher in grouper 1. for more detail you can review https://www.colorado.gov/pacific/sites/default/files/CMS1500_ASC.pdf

*Please tell where the services were rendered for more specific help...

Best Regards
Pankaj Gangwani

: Re: Payment Groupers
: jenhigh October 27, 2015, 11:15:36 AM

These services are in Virginia.