Wiki 38220, 38221 g0364

[traci.susong@gmail.com]

HI,

Do you bill the G-0364 add on code to commercial payers or the 38221? Also, do you indicate an RT or LT for right or left when performing the biopsy on one side?

 

[cycmkdill]

The G0364 is for Medicare patients. Commerical billers would be 38220/38221 and you would use the LT or RT modifiers.

Hope that helped!

 

[Tonyj]

HI,

Do you bill the G-0364 add on code to commercial payers or the 38221? Also, do you indicate an RT or LT for right or left when performing the biopsy on one side?

Please check NCCI guidelines on that particular procedure. You would need a 59 modifier and it must meet the NCCI guidelines.