by Brittney Murdock, QCC, CMCS, CPC
March 4th, 2019
Many denials can be avoided when you understand how a payer looks at a code. Find-A-Code puts a lot of this information all on one page. Under Additional Code Information on CPT codes, you will find a lot of questions can be answered.
In addition to the global policy, uniform payment policies and claims processing requirements have been established for other surgical issues, including bilateral and multiple surgeries, co-surgeons, and team surgeons. This is all found on the Additional Code Information page.
For example, look at the following CPT code and the indicators telling how this code is used.
28445 - Open treatment of talus fracture, includes internal
The first indicator is
We can see this is payable under OPPS, Hospital Part B through a comprehensive APC. This also tells us this is a packaged code and everything for this procedure is bundled with the exception of services with OPPS SI=F