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I have got a denial for Aetna insurance where CPT G0378 has been denied stating the cpt is bundled with 96374 which is for facility charges, Can anyone please suggest can i use modifier 25 with G0378 and refile the claim.
Thanks
Narashiman BPT, COC, CPC
CMS has said they plan on rolling out mandatory Medicare bundled payment models for cancer, and they are going to reconsider voluntary cardiac care bundled models, even though they had decided that cardiac care bundled care would not work. Bundled Models HHS Secretary Alex Azar indicated that although bundled payments for care is a voluntary […]
The post CMS Resurrects Bundled Payments appeared first on AAPC Knowledge Center.
Bundled payments seem to be cutting healthcare costs. One of the salient goals of the Affordable Care Act was to bring down the cost of care. As a result, the federal government attempted to assist in reducing the cost of care by implementing a program called Bundled Payments for procedures that are frequently performed […]
AAPC Knowledge Center
If the doctor opens a patient and finds an abscess on one portion of intestine (say transverse), drains it, and then performs a Hartman’s (not involving the transverse), can we bill a 49020-59 with it?
If the doctor opens a patient and finds pus and fecal matter in the abdomen due to perforation, drains it, and then performs a Hartman’s, can we bill 49020-59?
I know my opinion/thoughts on it but don’t want to sway anyone with them.
the procedure that is billable 48150-22 (Difficult due to lysis of adhesion) and omental flap 49905
Thank You