Coding > Coding
Medicare Reimbursement for 64555-SG, Surgical procedure
stacykelley:
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!
Merry:
Seems to me after doing a Google search that it is a facility fee for the ASC. Some of my searches showed that it is not used anymore and other searches contradicted this.
stacykelley:
Yes, that is exactly what I have found. Plus the reimbursement has varied from state to state. As the owner of this billing company, if he and all of his billers can't figure it out, I'm about finished trying. This has been a week-long interview with no pay and only stress :-\
Merry:
You are smart. Sounds like this would not be good fit. Hope you find a job that you will be appreciated at.
jessyp:
Same with me i dont found any solution. May be some ASC codes change.
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