State Applicable to Alert: Southern California
Background Information: Procedure codes included in the previous contractor’s Non-Invasive Peripheral Venous Studies Local Coverage Determination (LCD) were processed incorrectly by Palmetto GBA from January 1, 2009 to April 8, 2009.
Policy L20718 - Dates of Service October 1, 2006 to September 1, 2008
Applies To Procedure Code(s): 93978 and 93979
Remark/Reason Codes:
50 and N115 - This decision was based on a Local Medical Review Policy (LMRP) or LCD. An LMRP/LCD provides a guide to assist in determining whether a particular item or service is covered. View a copy of this policy.
MAC Action: A mass adjustment will be performed to correct the claims processed incorrectly.
Provider Action: No Action Required
Date Reported: March 11, 2009
Date Resolved: Mass Adjustment to correct claims paid in error was completed on April 16, 2009. A second Mass Adjustment to correct claims denied in error was completed on April 29, 2009.