Orthopedic Coding Alert

You can look forward to $48 more in reimbursement when you report G0289 with your chondroplasty claims, thanks to a new Medicare Transmittal.

On Sept. 1, CMS issued Transmittal 1047, which changes the multiple surgery payment indicator for code G0289 (Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage [chondroplasty] at the time of other surgical knee arthroscopy in a different compartment of the same knee) from -2- to -0.- This means that as of Oct. 2, Medicare carriers will no longer take the multiple procedure discount of 50 percent when you report G0289 with other procedures.

Because you cannot report G0289 as a stand-alone procedure, this change means that every time you bill G0289, you will collect twice the reimbursement that you collected in the past.
 
To read the full Transmittal, visit the CMS Web site at cms.hhs.gov/transmittals/downloads/R1047CP.pdf.
                                                        
Don't Forget to Resubmit 22612/22630 Claims

If your carrier denied any of your spine surgery claims due to the version 12.1 National Correct Coding Initiative edit bundling 22630 (Arthrodesis, posterior interbody technique, including laminectomy and/or diskectomy to prepare interspace [other than for decompression], single interspace; lumbar) into 22612 (Arthrodesis, posterior or posterolateral technique, single level; lumbar [with or without lateral transverse technique]), now is the time to resubmit those claims.

The NCCI has deleted the edit effective Oct. 1, so you can send your carrier a letter along with your resub-mission letting them know that you-re planning to col-lect for claims that they denied based on the previous edit. Gather all of your denials from April 1 through Oct. 1, because the edit deletion is retroactive to April.