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REVENUE CODE FOR A9576

Nicole Posted Fri 21st of June, 2013 18:37:02 PM

we had used rev code 255 for this HCPCS code A9576. Medicare has denied the claime stating rev code 255 with HCPCS code A9576 is invalid in combination with MRI (72158)
Please advise what rev code we should be using for this A9576?

SuperCoder Answered Mon 24th of June, 2013 12:26:02 PM

For this type of contrast, the associated revenue codes are 0343 or 0344.

Nicole Posted Mon 24th of June, 2013 17:35:54 PM

Can this please be reviewed again. The gadoteridol that was injection is a MRI contrast only not a radiopharmaceutical. The rev codes 0343 and 0344 are for radiopharmaceuticals.
Is this correct?

SuperCoder Answered Tue 25th of June, 2013 05:02:22 AM

Please check :

Source- Page 4 ; Para 3

http://www.centramed.co/documents/Net%20Revenue%20Matters%20June%202009.pdf

If you have any other queries do let me know.

Nicole Posted Tue 25th of June, 2013 12:34:42 PM

Thank you for this resource. It is correct.

Nicole Posted Wed 26th of June, 2013 19:55:55 PM

Please help we re-submitted this claim with cpt 72158 TC rev code 0255 and hcpcs code A9576 with 0343. And it got rejected again by Medicare stating invalid combination.

Nicole Posted Wed 26th of June, 2013 20:46:52 PM

I am really trying to figure this out so need your help please. We gave 20 ml of IV prohance. We have charged it with A9576 as paramag contrast 20CC as one unit. Would this have anything to do with it. Should it be documented as ML and quantity/units 20?

Nicole Posted Wed 26th of June, 2013 20:47:39 PM

should this be as a bundled charge with the MRI?

SuperCoder Answered Fri 28th of June, 2013 02:57:37 AM

Hi,

I saw one policy that said to report the same HCPCS, so that would be per ml for 0343 ... 20 in this specific case. I would also guess that the code for the MRI is wrong. I’d think something like 0612, MRT/MRI-spinal cord (including spine), would be more appropriate

I have forwarded this query to my editor. She will work on this and respond soon.

Thanks.

Nicole Posted Fri 28th of June, 2013 03:48:50 AM

THANK you want to clarify though we did use 0612 with the MRI 72158. I typed the 0255 wrong for the rev code. So I do not think it has to do with the MRI part. THank you will wait for your respons

SuperCoder Answered Fri 28th of June, 2013 13:18:21 PM

These are the list of applicable Rev. codes with CPT 72158:

0255

Pharmacy - Drugs Incident to Radiology

0972

Professional Fees - Radiology - Diagnostic

032X

Radiology - Diagnostic

035X

CT Scan

061X

Magnetic Resonance Technology (MRT) - MRI

096X

Professional Fees

098X

Professional Fees
_____________________________________________________________

So you can see that class 061x is best for 72158. Here are full Rev codes under that class. Please see your documentation of procedure performed and choose accordingly:

0611

MRT/MRI-brain (including brainstem)

0612

MRT/MRI-spinal cord (including spine)

0614

MRT/MRI-other

0615

MRT/MRA-Head and Neck

0616

MRT/MRA-Lower Extremities

0618

MRT/MRA-other

0619

MRT/Other MRI

Nicole Posted Fri 28th of June, 2013 15:01:48 PM

right we did use 0612 with cpt 72158
and then tried 0343 with A9576
Medicare is still rejecting this.
We have the hcpcs A9576 as 20 cc should this be 20 units ML
or have any ideas of why this is still rejecting please?

SuperCoder Answered Mon 01st of July, 2013 10:40:23 AM

CC and ML are equivalent to each other. So 20 CC = 20ML. The HCPCS code A9576 is for 1 ML, so for 20 CC/ML, bill 20 units of A9576 [A9576 x 20].

For rev. codes rejection, I am afraid that we cannot suggest anything specific, other than to suggest to appeal to MCR. You can ask for a written guidance from your MAC too in this case.

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