Wiki complicated coding scenario - please help

LINDA

Contributor
Messages
24
Best answers
0
If the physician sees an infant in the NICU and the visit is coded a 99479, and he also does a PICC placement 36568 (global to the 99479) plus sedation (99143), what exactly can be billed? Per the edits, the 99143 is included with the PICC placement, but since the PICC is global to the 99479, we won't be billing that separately. So does that mean we CAN bill the 99143? So would the correct codes be 99479 & 99143, or would it just be the 99479?

I appreciate your feedback!
 
I entered the info you shared in AAPC coder and this is what I rec'd back.
99479 a column 2 code which can have a modifier when billed with 36568
36568 a column 2 code which can have a modifier when billed with 99479
99143 is bundled with 36568 so it can't be billed. 36568 states moderate sedation included.

The way I read the edits I can bill 99479 with 36568 add modifiers as indicated. 59 distinct procedural svc.

Hope this helps.
 
My thought is, if the procedure is inclusive then the anesthesia necessary for the procedure is inclusive as well. Some things do not need to be in the edits to still be true. I say bill only the 99479
 
I was leaning towards the sedation not being billable since it's for a procedure that's not billable. Thank you for your responses.
 
Top