Wiki 77014 w/77385

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jflynn124

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We've always billed the 77014 with 77385 and gotten paid but now Cigna is denying the 77014 stating it's bundled with the 77385. I know the CPT book states that 77385 includes guidance and tracking but Cigna is the only insurance that's denying it. Is there something I'm not seeing? Do I have any valid basis for an appeal?
 
77385 includes guidance and tracking then it should be billed alone and perhaps Cigna 'caught' it and has denied.. I found this web site with FAQ maybe it can help you but from what I've seen in the past when guidance is billed separately it's only a matter of time before it can strike an 'audit' .. if Cigna has paid for those two codes in the past then you really want to do more research to make sure you cannot code these two codes together. Call another facility that does this type of service and ask how they bill .. you don't want to be involved in a huge take back.

https://www.astro.org/Daily-Practice/Coding/Coding-Guidance/FAQ-IGRT/
 
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