Chondroplasty by itself to Medicare

Cpolisena

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Can someone please help me with this. Most of us know to use G0289 for 29877 when billed with 29880 or 29881. But what code should we use if the chondroplasty is the only procedure being filed to Medicare, 29877 or G0289? Any and all advice is appreciated. Thanks-
 

Cpolisena

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Initially I tried that. The system we're on kicked it back saying- "Per Medicare, ASC surgery claims require an appropriate ASC modifier on procedure 29877"- Neither I or our office administrator know what they are talking about. But yes, the surgery was done in our ASC. The claim won't even drop without adding some kind of modifier. So, if there isn't a modifier that you or anyone else knows of, then I need to call our system headquarters and have them clear that rule out.
 

trose45116

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i agree with mbort 29877 is the correct code to use....as for the other question i thought you have to use the SG modifier when billing to medicare....correct me if im wrong.
 

elenax

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Modifer SG is not valid for Medicare as of Jan, 2008. What about adding modifier LT or RT to identify anatomic.
 

mbort

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I agree with Noraz, try the rt/lt and if that doesnt work then I would have them clear the rule as there are no other modifiers that I am aware of that would prevent the claim from being a stand alone, payable claim.
 

Cpolisena

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I actually had the RT on it, so unfortunately that's not it either. I'll have one of our insurance personnel call Medicare and see if they can't get an answer.
Thanks to all of your for helping. If I find anything out that will help, I'll post the answer in case someone else comes across the same issue. Thanks again-Chris
 
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