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Solesta Injection L8605

Lee Posted Thu 18th of July, 2013 20:06:35 PM

I am having trouble getting the 46999 paid with the Solesta Injection code (L8605)through medicare. Any suggestions

SuperCoder Answered Fri 19th of July, 2013 01:35:26 AM

No matter how thorough you are, don't be surprised if you have to appeal to get paid using this unlisted-procedure code.

To increase your chances of initial reimbursement, call your private payers before filing a Secca claim and ask what they want to see on a claim.

The payer will probably tell you to remember to attach documentation of other, more conventional attempts at treatment for fecal incontinence, such as using fiber or biofeedback.

No private carrier is likely to pay for Secca if some other treatments haven't been tried first.

The payer will also tell you to include proper diagnosis codes for fecal incontinence -- such as 307.7 (Encopresis [continuous] [discontinuous] of nonorganic origin) and 787.6 (Incontinence of feces).

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