BlueCross BlueShield of Kansas has recently discovered they have been paying 6 base units for cataract surgery, CPT 66984, ASA 00142, instead of the allowed 4 base units, creating an overpayment of 2 units per case. This error has been going on for some time; however, contractually, BlueCross BlueShield cannot request refunds or take recoups on overpayments further than 15 months from the date of adjudication.
Initially, BlueCross BlueShield notified ABI they would send out refund requests for these overpayments; however, ABI has started seeing the recouping and auto-deducting of payments coming through for some providers. Some of these recoup payments are being seen on single remits. Please be advised of this issue as this will undoubtedly affect your monthly revenues to some degree, based on how many cataract surgeries you perform.
Please do not hesitate to call our office if you have any questions regarding this matter.
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The information included in this publication is provided, among other things, to alert you to legal developments and should not be considered legal advice. Specific questions about how this information affects your particular situation should be addressed to your attorney.
Editor: Philip Blann (pblann@anesthesiabilling.com).
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