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CodeMap® Compliance Briefing: 6/01/07


Editor's Welcome:

Today, we will discuss how Medicare pays for "unlisted procedure" codes. These special purpose CPT codes are not included in either the Medicare Laboratory Fee Schedule or the Medicare Physician Fee Schedule, and are reimbursed at the discretion of individual Medicare contractors.  However, as illustrated below, it appears that reasonable reimbursement is possible, if a laboratory is willing to work with its Medicare contractor. As always, please let us know if you have any questions or comments or wish to share your experience with using these troublesome codes.

Sincerely,

Gregory Root, Esq.


Reimbursement for "Unlisted" Procedures 

by: Charles B. Root, Ph.D.

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