Question: C AN Someone help me with this case study it is for Coding Two months ago, your organization-initiated pain management services. In recent weeks, you
CAN Someone help me with this case study it is for Coding
Two months ago, your organization-initiated pain management services. In recent weeks, you have watched the accounts receivable for Medicare slowly climbing. You begin to audit the accounts that are outstanding and realize the reason for the increase is pain management operative procedures, specifically sacroiliac joint injections. These were all billed with CPT Code 27096 at approximately $410.00 per case with average of 5 cases per day over the past two months. They all have an Outpatient Code Editor (OCE) edit of 28. Determine what your next steps should be resolve this issue and reduce the accounts receivable.
OCE edit #28-CMS does not accept CPT code 27096
G0260 is a valid 2020 HCPCS code for Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography or just " Inj for sacroiliac jt anesth " for short, used in Ambulatory surgical center. G0260 has been in effect since 10/01/2004
Estimate potential loss at Twenty(20) cases per month(40 cases)= Total dollars needed
Think about the next 3-4 steps that should be taken as a result of these findings
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