Natalie Posted Wed 13th of March, 2013 16:47:23 PM
MY DOCTOR BILLED FOR 38724 60240 38542, AS OUTPT, WE WERE PAID BY CARRIER, BUT THEN THEY RECOUPED $$ BACK ON CPT CODE 38724 STATING CODE NEEDS TO BE BILLED AS OUTPT, IS THIS CORRECT?
SuperCoder Answered Thu 14th of March, 2013 13:01:16 PM
38724=This code is not an ASC approved procedure. ( Medicare OPPS schedule)
According to Medicare's fee schedule, this has an OPSI code of C - inpatient procedure.
This is the reason they recouped money.