77002-77003

[tadavis]

question:

is 77002-77003 included in 64520?

 

[kevbshields]

They are not bundled per CCI edits.

I'm guessing a payer is giving you "up the road" about their being inclusive?

I'd blame that on McKesson's and its conservative and often errant interpretations of "bundling." The Fluoro use is sound medical/clinical practice, but not inherent to the procedure. The service (64520) may certainly be done without fluoro. By the way, 77003 is the one you'd want to use with the code mentioned.

Hope this helps.

Good luck.

 

[tadavis]

Thanks Kevin--the ins co is giving me pure _ _ _ _ about this--even when I send the op notes they are still giving it to me

 

[kevbshields]

I'd lay money on their use of McKesson's!

Are you -26-ing the Fluoro (assuming it's hosp-based or sim.)?

Also, demand medical review (by MD) and if that doesn't work, hang on to every one of them, contact the DOI for your state and see about filing a complaint (when you've got 10-20 or more).

Just an idea . . .

LOL.

 

[AnthonyBush]

There are no Mckesson edits on those 3 codes. Its probably the individual payors assumption or one of thier edits.