Medical Billing Forum

Billing => Billing => Topic started by: dekenn on October 29, 2010, 01:37:26 PM

Title: xray reimbursement
Post by: dekenn on October 29, 2010, 01:37:26 PM
Has anyone else had an insurance reduce the reimbursement for x-rays due to "multiple procedures"?  This is the first time that I billed 73620 RT and 73620 LT and had the insurance company reduce the second by 50%. When questioned, they said that because it's the same diagnosis (valgus), they cut the second in half.  I know that the bilateral indicator is "3" according to Medicare, which says it's not a code that's subject to reduction, but what other argument can I use besides "Medicare says so"???? :-\
Thanks for any input!!
Title: Re: xray reimbursement
Post by: Michele on October 29, 2010, 03:57:44 PM
Was it a commercial carrier?  Were you billing global, or just professional component?  I haven't had this problem, but hard to comment without a little more info.

Title: Re: xray reimbursement
Post by: Priyan on November 16, 2010, 11:57:08 PM
Yes, Usually Insurance could make a payment of 50 - 50 or at changes can make payment at 100% rate clubing CPT with Bilateral.

But here the case do require further more information to understand the cause.

Please Share the insurnace and the billing method we adopted to look into it carefully.