mercredi 3 décembre 2014

Place of Service question

Our general surgeon billed a 62223-62, co-surgeon, with a place of service 22, outpatient hospital. We received a denial from the insurance carrier (Insurance carrier is a commercial plan, not Medicare or Medicare Part C) advising the procedure is not usually "in" the place of service reported, per CMS guidelines.

I checked into the code and found it has an ASC payment indicator of C5-inpatient procedures.


Can anyone help me with this question--Is payment of services under the Medicare Physician Fee Schedule indicative of payment indicators for ASC / OPPS? i.e. the denial we received for professional services (62223) is being based on Ambulatory Surgery Center payment indicator rules.


Thanks!






Place of Service question

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