DecisionHealth, DecisionHealth - 2012 Issue 10 (October)

Ask a Part B News expert: Billing bladder scans and complex catheterizations

Can we bill for both a bladder scan (51798) and complicated catheterization (51703)? Our Medicare administrative contractor, Wellmark, says the catheterization is included in the allowance of the bladder scan. But its Improve the Claims Adjudication Process (ICAP) edits policy contradicts that while CMS’ policy does not allow for a complicated catheterization in conjunction with a bladder scan performed in an office setting on the same day. Were they right to deny our claim?

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