Medical Billing & Medical Coding Blog...

Medical Billing » Blog » Medicare-No Pay For Certain Gastric Procedures

Medicare-No Pay For Certain Gastric Procedures

Medicare-No Pay For Certain Gastric Procedures

If you are a physician that does regular gastric by-pass procedures, you need to know that as of March 17th, Medicare will no longer reimburse the code 37216 which is transcatheter placement of intracatheter stents according to their latest transmittal from the Centers for Medicare & Medicaid Services.

Other changes that are coming soon will be to the physician reimbursement fee schedule. New medical billing claims need to show code 37216 to have the status code of “R,” and carriers should adjust their systems to “reflect a non-coverage status” for this particular code. Another change in the gastric medical billing category will be to restrictive procedure code 43842 that will have a status code of “A” assigned. This will designate that the procedure will also be non-covered by Medicare.

The new transmittal further revises descriptive modifiers for Category II modifiers 1P and 2P, and adds another modifier 3P make sure that your documentation of the gastric procedure performed matches the modifiers used. Make sure that you’re getting the maximum reimbursement for the procedures you perform and also make sure that your medical coding and billing reflects changes with Medicare so you know if you will be reimbursed for a procedure performed or not.

View all Articles by:

Be The First To Comment!

New comments are no longer accepted on this article.

Subscribe To Article Updates By Email

Submit this form to receive an email when a new article is published to our blog.

Your email address:

(Your email will never be given or used for anything but this article subscription) - privacy policy

Google Reader or Homepage Add to My Yahoo! Subscribe with Bloglines Subscribe in NewsGator Online Add to Technorati Favorites!
Blog Sections
Blog Archives
Professional Affiliations
Connect With Us
Tweets by This Author
Feedback
The medical billing blog with billing and coding articles!
Medical Billing & Coding Articles!