Author Topic: Billing for anesthsia codes, Medicare denials  (Read 1045 times)

Ruthie1972

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Billing for anesthsia codes, Medicare denials
« on: February 12, 2016, 08:39:25 AM »
HI
I hope someone can help me. I have been billing DX of H25.9, H25.11 and H25.12 for anesthesia and Medicare keeps denying due to HCPCS. Has anyone else encountered this? What DX should we be using? Thank you.

Michele

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Re: Billing for anesthsia codes, Medicare denials
« Reply #1 on: February 12, 2016, 10:27:28 AM »
I'm not sure what you mean by "denying due to HCPCS".  You only gave the ICD10 codes and the denial is due to HCPCS.  More info??
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Ruthie1972

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Re: Billing for anesthsia codes, Medicare denials
« Reply #2 on: February 12, 2016, 10:40:46 AM »
Hi Michele
Thank you for your reply. I am getting denials from Medicare on these for CPT code 00142 and the DX initially was H25.12 which is age related nuclear cataract for r eye. Then we changed to H25.9 and they are still denying it. Both denials stated due to HCPS? I am not sure why either. I thought if anyone else saw this they could shed some light. I will be calling them as well.  thanks so much.

Michele

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Re: Billing for anesthsia codes, Medicare denials
« Reply #3 on: February 15, 2016, 07:25:32 PM »
Well if the denial is due to the HCPCS then changing the dx won't make a difference.  When you say "denied due to HCPCS" what is the exact denial?
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PMRNC

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Re: Billing for anesthsia codes, Medicare denials
« Reply #4 on: February 16, 2016, 07:33:35 PM »
If you are billing anesthesia, and getting these denials, you will want to consult with the surgeon's office and review the Op reports.

Linda Walker
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Ruthie1972

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Re: Billing for anesthsia codes, Medicare denials
« Reply #5 on: February 17, 2016, 07:14:29 AM »
Thank you both, these are Medicare claims, I am going to call and I will find out and let you know what they came up with. Have a great day.