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Old 05-31-2011, 04:30 PM
sweetybird0472 sweetybird0472 is offline
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Question MCS and CPT bullseye symbol?

Do ALL procedures in the CPT book that include MCS have the bullseye symbol included?

Or like so many other things in coding is it random?

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Old 05-31-2011, 05:42 PM
clsteph1 clsteph1 is offline
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The procedures that include Conscious Sedation according to the AMA do include a bullseye in the CPT book. Certain payers may bundled conscious sedation into additional procedures. You'll want to check the NCCI edits and your payer policies, etc.
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Old 05-31-2011, 06:45 PM
sweetybird0472 sweetybird0472 is offline
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Chandra,

Thank you again.

Okay for this instance, the procedure code was 64721. I'm in a classroom setting. I just looked at the NCCI edits and it does have the following codes with a 0 modifier not allowed.

64721 / 99148
64721 / 99149

Now my question is this. This would only be for a different physician providing the sedation, but if the physician that was performing the carpal tunnel release administered the sedation then code 99143/99144 (depending on time) would be coded in addition to the procedure as I do not see them in the NCCI edit list.

I'm asking because my instructor told me that sedation is always included in this code and it is "just one of those things you will learn with experience". She never mentioned checking the NCCI edits or that it could vary depending on the payer.

Thanks!
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Old 06-01-2011, 01:34 PM
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The code pair in NCCI with a "0" modifier status would indicate that these codes cannot be billed together by the same physician. Not all payers follow NCCI so you could still bill it to commercial payors but you're likely to find that very few payers will reimburse for conscious sedation regardless of the procedure or who the surgeon was.
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