tci Outpatient Facility Coding Alert - 2012 Issue 2

Reader Question: Double Check Before Submitting ICD-9 Codes for ASC

Question: We use CPT® codes in our ASC, but one of our insurers is requesting ICD-9 procedure codes for 64483 and 64484. Any ideas what we should report?  Utah Subscriber Answer: This is an unusual situation, with the payer requesting Vol. 3 procedure codes since those aren't normally required for an outpatient claim. You might want to verify the request with the payer and remind them that ICD-9 Vol. 3 codes are the specified HIPAA standard code set for inpatient hospital procedures and shouldn't be reported on outpatient claims. If they insist on having ICD-9 procedure codes, however, the...

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