Wiki Bilateral nephrostogram

[njwanucha]

We are having a discussion in our office regarding the charging of 74425 twice even though there is an MUE of 1 and neither a 50 nor Lt & Rt modifiers can be used. Coders are under the impression that the S & I code 74425 should only be charged once and the injection procedure 50394 can be coded with a 50 modifier. The Radiology tech thinks 74425 should be charged twice with a 59 modifier on one of them.

Does anybody have a definitive answer on this? I have checked Dr. Z, Medicare website, etc. and can't find an argument in the coders' favor. Any ideas would be greatly appreciated!

 

[dpeoples]

We are having a discussion in our office regarding the charging of 74425 twice even though there is an MUE of 1 and neither a 50 nor Lt & Rt modifiers can be used. Coders are under the impression that the S & I code 74425 should only be charged once and the injection procedure 50394 can be coded with a 50 modifier. The Radiology tech thinks 74425 should be charged twice with a 59 modifier on one of them.

Does anybody have a definitive answer on this? I have checked Dr. Z, Medicare website, etc. and can't find an argument in the coders' favor. Any ideas would be greatly appreciated!

I code 74425 once, for each side injected. That means it can be coded twice per session, IMO, and our payor prefers modifier 76 for the second.

HTH

 

[njwanucha]

Thank you very much!