DecisionHealth, DecisionHealth - 2023 Issue 9 (September)

Q&A: Pay attention to Medicare POS limits for procedures in non-facility (office) setting

Question: We had a provider perform an excision of prepatellar bursa (27340) in the office, place of service (POS) code 11. Patient has United Healthcare Shared Services-GEHA insurance. They denied the claim stating that CPT 27340 is not billable with POS 11. I have never had this issue before. Are there any coding rules/guidelines that prohibit use of some CPT codes at certain places of service or is this some weird payer-specific rule?

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