Prolotherapy / Nail Debridement Billing

3/28/2018

Prolotherapy

Please be reminded that claims billed for trigger point injections, CPT 20552-20553, billed without the appropriate J-Code will be denied.  Claims with dates of service 7/1/2017 – current must have the appropriate J-Code.  If you have originally submitted without the appropriate J-Code, you may resubmit with a corrected claim.  Our claims department may be recouping on claims during this period that have been billed inappropriately. 

Nail Debridement

Please note that claims submitted for nail debridement must follow the LCD from Noridian Medicare.  Proper diagnosis and modifiers must be submitted to ensure your claim is processed and paid.  Claims with dates of service 7/1/2017 – current must have the appropriate diagnosis and modifiers, per the CMS LCD.  We have provided the link below.  If you have originally submitted with incorrect diagnosis codes, you may resubmit with a corrected claim.  Our claims department may be recouping on claims during this period that have been billed inappropriately.

 

https://med.noridianmedicare.com/web/jfb/specialties/podiatry


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