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When submitting claims that include 97799, they go to suspense location, S MOUTP, why?

April 26, 2017location SUSPENSE

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When submitting claims that include 97799, they go to suspense location, S MOUTP, why?

1 Answer

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Posted

The physician fee schedule abstract file does not contain a price for 97799. Therefore, the Fiscal Intermediary (FI) must contact the carrier to obtain the appropriate fee schedule amount in order to make proper payment for this codes.