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Wiki Billing a 64405 and 20552 with Medicare

Thread starter januaryl1978
Start date Jul 28, 2023

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januaryl1978

Guest

Jul 28, 2023

#1

Can a 64405 and 20552 be billed together in the same day with Medicare? If so, would modifiers need to be attached?

A

amyjph

True Blue

Jul 30, 2023

#2

You can look it up using NCCI.

https://www.cms.gov/medicare-medicaid-coordination/national-correct-coding-initiative-ncci/ncci-medicare/medicare-ncci-policy-manual

https://www.cms.gov/medicare-medicaid-coordination/national-correct-coding-initiative-ncci/ncci-medicare/medicare-ncci-procedure-procedure-ptp-edits

Some of the MACs have a handy edit checker too: https://www.cgsmedicare.com/medicare_dynamic/j15/ptpb/ptp/ptp.aspx
Most coding software also has this such as Optum Encoder, etc.

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