Wiki Column 1 & Column 2

[nlbarnes]

Encoder has given an edit on:

52610 Ok to bill w/ no modifier

51050 Column 1
51525 Column 2 (separate procedure) HIGHER RVUs than 51050

Does the guidelines state that you have to bill the Column 1 code (which has lower RVUs) instead of the Column 2 code?

Obviously, we are billing 52610 as the primary code.

 

[danskangel313]

Encoder has given an edit on:

52610 Ok to bill w/ no modifier

51050 Column 1
51525 Column 2 (separate procedure) HIGHER RVUs than 51050

Does the guidelines state that you have to bill the Column 1 code (which has lower RVUs) instead of the Column 2 code?

Obviously, we are billing 52610 as the primary code.

Are you certain about 52610? I get that as a deleted or invalid code.

Because the description for 51525 Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) includes the "separate procedure" part, that means you could only bill that service if it was the ONLY thing done that day in the same site. If any other procedures were done at the same location, it would get bundled for that reason, not based on RVUs. The same concept applies to any code that includes "separate procedure" in the description.