Bundling of procedures

[ssebikari]

If two procedures are performed by two different physicians billing under the same Tax ID, for example CPT 63075 & 95920. Dr X performs 63075 and Dr Y performs 95920, both physician bill under same tax ID. Would CPT 95920 be considered bundled? or can Dr Y also bill seperately?
Looking for confirmation!
Thanks

 

[martnel]

Can you not use modifier 62 in a case like this?

 

[RebeccaWoodward*]

According to CCI edits, 63075 and 95920 have an bundling indicator of 0. 95920 is bundled into 63075 and can not be overridden with modifier 59.

 

[ssebikari]

Rebecca, yes they are bundled and and mod 59 is not applicable, the question is does it matter if procedures are done by two different physicians same tax ID, two different reports..... is there anything in writting that I can use?

Martn mod 62 is not applicable to 95920 and neurophysiology testing was performed after the discectomy.
Thanks all for your input

 

[vikas.maheshwari]

I think you have to bill 63075 for first physician and 95920 for the second without using any modifier.

 

[RebeccaWoodward*]

I'll reference CMS' guideline........

Intraoperative neurophysiology testing (CPT code 95920) should not be reported by the physician performing an operative procedure since it is included in the global package. However, when performed by a different physician during the procedure, it is separately reportable by the second physician. The physician performing an operative procedure should not bill other 90000 neurophysiology testing codes for intraoperative neurophysiology testing (e.g., 92585, 95822, 95860, 95861, 95867, 95868, 95870, 95900, 95904, 95925-95937) since they are also included in the global package.

Located in Chapter 11

http://www.cms.hhs.gov/NationalCorrectCodInitEd/

 

[ssebikari]

Thanks for the feedback