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Medicare denials for A9502

Heather Posted Thu 14th of February, 2013 15:13:21 PM

Medicare is denying A9502 even after putting cost =$99 in box 19. I do not know what else to do to get this paid. NDC info is also entered with CPT. Thoughts?

SuperCoder Answered Mon 18th of February, 2013 05:42:57 AM

If you are performing both the technical component and the professional component you should only bill 78452, that would be the global which includes both. You may be getting denials because you are separating them out on a single claim submission.

SuperCoder Answered Mon 18th of February, 2013 05:44:39 AM

When billing for the purchase of radiopharmaceutical(s), a copy of the bill indicating the dosage administered, unit price per dose, name and total charge of the radioactive drug must be made available to Medicare upon request. Private payers have their own policies on A9502 and A9505. When requesting a written redetermination (formerly appeal), providers must include all relevant documentation with the request. 93015: Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with physician supervision, with interpretation and report (You are not in an outpatient setting, if billing this code.). Code 99070 will be bundled (why is this being billed?). See if this article helps because it is difficult to answer based on this information.

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