Wiki Billing Inpatient Hospital Visit with Chemo LP 96450

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Shay0287

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Hi,

Does anyone know how to bill an inpatient hospital visit (e.g., 99222, 99232) with a Chemo Lumbar Puncture 96450. There is a CCI edit for 96450 when billed with any inpatient E/M codes. Column 2 code is 96450 which means that the modifier will go on 96450. I can't find anything regarding this code not being able to be billed with an inpatient visit
 
Hi,

Does anyone know how to bill an inpatient hospital visit (e.g., 99222, 99232) with a Chemo Lumbar Puncture 96450. There is a CCI edit for 96450 when billed with any inpatient E/M codes. Column 2 code is 96450 which means that the modifier will go on 96450. I can't find anything regarding this code not being able to be billed with an inpatient visit
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Was something else being coded? Insertion of catheter, Fluor0 guidance, the lumbar puncture itself? If so you would need a 59 modifier or X (EPSU) modifier.

Cheryl Anderson LPN, CPC, CPC-I, CEMC
 
Thanks for responding. No nothing else is being billed, only CPT 99222 and 96450 which have a CCI edit and 96450 is the column 2 code. I thought it was inappropriate to use modifier 59 or X modifiers when billing a procedure with an E/M service. Usually you would use modifier 25 with the E/M service but the column 2 code is not the E/M it is the 96450. I cannot find anything stating that these two cannot be billed and CCI states a modifier is allowed. Should I just use modifier 59 or X anyway?
 
Andrschery said:
Was something else being coded? Insertion of catheter, Fluor0 guidance, the lumbar puncture itself? If so you would need a 59 modifier or X (EPSU) modifier.

Cheryl Anderson LPN, CPC, CPC-I, CEMC
Click to expand...

Thanks for responding. No nothing else is being billed, only CPT 99222 and 96450 which have a CCI edit and 96450 is the column 2 code. I thought it was inappropriate to use modifier 59 or X modifiers when billing a procedure with an E/M service. Usually you would use modifier 25 with the E/M service but the column 2 code is not the E/M it is the 96450. I cannot find anything stating that these two cannot be billed and CCI states a modifier is allowed. Should I just use modifier 59 or X anyway?
 
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