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Wiki 76000

kristinab

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I need some help with the 76000 code. A doctor uses fluoroscopic guidance for a procedure and Medicare guidelines state that the 76000 code should not be billed with a procedure. The doctor is fighting back stating it doesn't matter if it's a guideline, because of the fact that their Code-X program states that it can be billed and not bundled. Should I be billing that code?
 
When it comes to Medicare patients, Medicare guidelines supersede any "coding product"...my opinion, of course. Direct your physician to this particular NCCI edit for the "70000" code section. Per CMS....(page 6)

"Many interventional procedures require contrast injections for localization and/or guidance. Unless there are CPT instructions directing the physician to report specific CPT codes for the localization or guidance, the localization or guidance is integral to the interventional procedure and is not separately reportable."

http://www.cms.hhs.gov/NationalCorrectCodInitEd/

Select the "NCCI Policy Manual" link....open up chapter 9
 
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