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A9279 recoup

PostPosted: Wed Nov 11, 2015 12:40 am
by ccsdc-dme
We have started to get hit with recoup requests from BlueShield for billing A9279. Has anyone else experienced this recently? Has anyone had any level of success with appealing these?
This appears to have just started and I have heard from others that they are to are getting recoup requests.

Thanks for any advice that can be presented.

Re: A9279 recoup

PostPosted: Thu Nov 12, 2015 1:09 am
by somnonaut
What is this code in reference to? ... stem/A9279

Polysomnography includes ALL OTHER monitoring that is performed above the standard configuration.

Re: A9279 recoup

PostPosted: Thu Nov 12, 2015 2:39 pm
by ccsdc-dme
This code applies to cpap equipment including remote monitoring software and wireless monitoring devices, as well as the SD card. Suppliers should bill A9279 when providing the equipment to the patient, including the SD card at setup or when providing and using the wireless monitoring device to remotely transfer compliance data.

This is a HCPCS code specific to a monitoring feature device that is billable by DME suppliers.

We have billed for this and Blue Cross was paying for this until recently. Now they are hitting us with recoup. You would think that if it was not billable they would have denied it.

It appears that this is now considered a bundled service.