Medical Billing Forum
Billing => Billing => : cflorez October 23, 2019, 04:29:38 PM
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Does anyone know where i can obtain information on a CPT code. Medicare has denied CPT 21248. We use it in the Oral surgery medical side.
I want to know where Ii can read the definition of the codes, how it is to used. Medicare is just denying but doesn't give a real definitive answer as how we used it in a wrong way. I have made several phone calls and nobody know nothing.
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Def: CPT 21248, Under Repair, Revision, and/or Reconstruction Procedures on the Head. The Current Procedural Terminology (CPT) code 21248 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Head.
What is the denial reason/code? Have you searched the LCD/NCD for that code?
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What I am looking for is the ability to read this CPT code. I have the name of that code you provided above. But what I want to do is ready the breakdown description. How this code is intended to be used. Once again Medicare is so vague and not transparent. Medicare is denying this code as we did not do this procedure properly. But give us no other information.
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Do you not have access to a CPT code book? If you need the detailed description of the code that is really the only place you can obtain it. Medicare denial codes usually don't say that the procedure wasn't performed properly. Maybe if you share the denial code we can help. Was the 21248 billed alone? Were there other services on the same date? What was the diagnosis?
Sorry, just not enough info to really help much.
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The better approach will be to cell medicare customer support and get all the possible information and act accordingly.
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Thank you all for your comments. I am going to follow up on your comments
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As far as I can tell it's not a covered procedure by Medicare, but you can check for LCD by entering your region and cpt code here:
https://www.cms.gov/medicare-coverage-database/overview-and-quick-search.aspx?