Author Topic: xray reimbursement  (Read 2298 times)

dekenn

  • Jr. Member
  • **
  • Posts: 85
xray reimbursement
« on: October 29, 2010, 04:37:26 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!!

Michele

  • Administrator
  • Hero Member
  • *****
  • Posts: 5927
    • Solutions Medical Billing
Re: xray reimbursement
« Reply #1 on: October 29, 2010, 06:57:44 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.

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Priyan

  • Newbie
  • *
  • Posts: 31
Re: xray reimbursement
« Reply #2 on: November 17, 2010, 02:57:08 AM »
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.
Priyan.D
Pleasure in Job, brings Perfection in work

Medical Billing Forum

Re: xray reimbursement
« Reply #2 on: November 17, 2010, 02:57:08 AM »