Wiki 22633/63047 2 different specialties same interspace same session same day

[jrclark1987@yahoo.com]

Can anyone help me find the most up to date medicare guidelines on this.
Neuro Dr. A bills 63047 and Spine Dr. B bills 22633. Should this be a co-surgery or is it appropriate to bill the codes separately even though it is bundled per CCI? If anyone has a great link explaining this i would greatly appreciate it. I have exhausted my resources. thank you.

 

[Vannoyj]

I just looked up the NCCI edits for 22633 and 63047 which shows 1 - Modifier allowed. Of course I do not know the exact DOS you are working with.

22633 63047 20120101 * 1 Misuse of column two code with column one code

 

[jrclark1987@yahoo.com]

thank you

I know you can use a modifier ONLY if the 63047 is performed at a separate interspace for the same provider. I cant find anything for when 2 separate providers/specialties perform this at the same interspace.

 

[mitchellde]

If you have a medically necessary reason for two different providers performing two procedure that would otherwise bundle together, then use an XP modifier on the code that is considered bundled. No guarantees that it will pay, however as I said if you have a really good reason as to why this was done this way then You could appeal it.