Monday, December 7, 2009

What will happen if Current Procedural Terminology (CPT) code 95992 is bill alone?

Answer : If billed alone, this code will be denied. On remittance advice notices for claims so denied, Medicare contractors will use group code CO and claim adjustment reason code 97 ("Payment is included in the allowance for another service/procedure.") Alternatively, reason code B15, which has the same intent may also be used by your Medicare contractor.


Reference: http://www.cms.hhs.gov/mlnmattersarticles/downloads/MM6407.pdf

http://www.cms.hhs.gov/transmittals/downloads/R1706CP.pdf

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