Natalie Posted Wed 13th of March, 2013 16:53:13 PM
MY DOCTOR BILLED FOR CPT CODES 38724 60240 AND 38542, AS OUTPT, THEY WERE ALL PAID BY THE CARRIER, BUT THEN THEY RECOUPED MONEY ON CPT CODE 38724 STATING CODE NEEDS TO BE BILLED AS INPT, WE HAVE BILLED THIS CODE IN THE PAST AS OUTPT AND HAVE GOTTEN PAID, DOES THIS SOUND RIGHT TO YOU??
SuperCoder Answered Thu 14th of March, 2013 13:00:22 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.