Just wanted to add this since I was in a hurry before.
Here is the link to the MedLearn article on the CMS Bulletin:
www.cms.hhs.gov/MLNMatter...MM5347.pdf
Apparently, Medicare had duplicate payments going to the hospital and provider who were both billing TC components for testing. Therefore, an edit was put in place which denies any claim from a physician office from the start date of admission to the discharge date that use a TC component (this means that global codes such as 93307 are included because it includes the TC component). Unfortunately, they didn't count on the fact that many patients are admitted to the hospital AFTER testing has been performed in an office setting. They currently have no capability to report the time of the encounter and therefore, an appeal must be written. You cannot call redetermination. It's caused a...
Here is the link to the MedLearn article on the CMS Bulletin:
www.cms.hhs.gov/MLNMatter...MM5347.pdf
Apparently, Medicare had duplicate payments going to the hospital and provider who were both billing TC components for testing. Therefore, an edit was put in place which denies any claim from a physician office from the start date of admission to the discharge date that use a TC component (this means that global codes such as 93307 are included because it includes the TC component). Unfortunately, they didn't count on the fact that many patients are admitted to the hospital AFTER testing has been performed in an office setting. They currently have no capability to report the time of the encounter and therefore, an appeal must be written. You cannot call redetermination. It's caused a...
