Medicare Compliance & Reimbursement - 2009 Issue 11
Reader Question: You Won't See $$ For Clip Placement
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Article Overview
This article explains a reader question about whether a breast biopsy-related add-on service can be reported and why reimbursement may still not be available. It is aimed at coding professionals who work with surgery, breast procedures, and facility billing, and it discusses the general relationship between CPT reporting, RVUs, and payment in inpatient or outpatient hospital settings.
Why This Topic Matters
It helps coders understand the distinction between reporting a service and receiving payment for it, especially when facility payment rules affect physician reimbursement.
What You Will Learn
- How a breast-biopsy-related add-on CPT service is discussed in relation to reporting and payment
- How RVU components relate to physician and facility reimbursement concepts
- How place of service can affect whether payment is associated with a reported service
- Why a code may be reportable even when separate reimbursement is not available
Who Should Read This
- Medical coders
- Coding auditors
- Biller/reimbursement staff
- Surgery practice staff
Codes Discussed
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