I have been charged with a mission from a prospective employer to solve this problem contingent on his hiring me. I have little info other than this:
The code 64555-SG has been billed to Medicare by a prospective client of theirs, and although the standard of reimbursement by Medicare is in the $700-$800 range, this client presented an EOB showing that 64555-SG being paid at $3800. It was billed under Medicare part B, I am told it was only billed as 1 unit. I don't know if it was billed under the provider or the facility. Our location is Southern California, and this EOB allegedly is from the same jurisdiction. The Noridian website indicates that this code reimbursement is in the $700-$800 range, so I can't figure out how this client was paid $3800 (multiple payments for multiple patients on the same EOB).
If anyone has any information to help me, I would be so very grateful. It may land me a job!