Wiki CPT for botox injection into bladder **help**

Create Wiki
B

bill2doc

Expert
Messages
455
Best answers
0
I know that this has been brought up in the past but it's been a while and wanted to see if anyone has been getting paid. I've seen three seperate threads and I'm confused by the codes. Can anyone help and let me know what codes/Modifiers you are using. Any help would be much appreciated. THANK YOU!!!

ONE:
53899
J0585x units

TWO:
52000
64640

THREE:
51715

Doctor is injecting botox into the bladder via Cysto (Intravesical botox injection)
 
Thanks Kelly, can you clarify what you mean by "compare it to" ? Are you using both codes with a modifier or just one or the other? Thanks so much

Lynn
 
When I use an unlisted code, I provide documentation and a letter to the insurance telling them why I used an unlisted code. I give them an available CPT that my unlisted procedure is similiar to. I also base my fee for the unlisted code to the "benchmark" procedure.
 
we use 53899 in our office and list the description... if a cysto is done with we use 52005 also
 
Stacy, do you use any modifiers when billing both? Also, how do you come up with a fee to charge for 53899? I don't see this code on the Medicare fee schedule to give me a base price.

Thanks so much
Lynn
 
Kelly,

Same question. I don't see code 53999 in the book or fee schedule??? Could you mean 53899? Also, how do you price the claim as I don't see a fee on the Medicare fee schedule.

Thank you again so much!
 
Yes, typo! Sorry about the confusion. Since I compare my service to 52327, I base my unlisted fee close to 52327.
 
You must log in or register to reply here.
Top