Wiki discography

[vjefcoats]

Hello!

Can we bill 62290/62291 for ASC? We billed medicare for 62290 and they denied as included in another service/procedure. They did pay the physician side of charge. Thanks for any input.

Vicki Jefcoats, CPC

P.S. Can the NCCI's be downloaded from the MC website????

 

[rkmcoder]

(These are my opinions and should not be construed as being the final authority. Other opinions may vary.)

62290/62291/72285/72295 for ASCs are Medicare 'N1' codes and are not reimbursable by Medicare, and should be billed with a GY modifier. You should probably reassess whether to do these for Medicare patients, since you do them for free in an ASC. Google 'NCCI edits' and you will be on your way to finding the CMS zipped downloads. Also google 'Final ASC Covered Surgical Procedures for CY 2010' to find your way to CMS zipped downloads for ASC covered services.

Richard Mann, your pain management coder
rkmcoder@yahoo.com

 

[dwaldman]

It has been requested that 62290-62291 be added to the ASC approved list of procedures but they said no. Here is their response.

http://bulk.resource.org/gpo.gov/register/2005/2005_23701.pdf


Response: We consider the
procedures coded 62290 and 62291 to
be integral to radiologic studies and are
never performed alone and, as such, are
not appropriate for addition to the ASC
list. Radiologic studies that do not
include an intervention are not
considered surgical procedures and are
not included on the list of ASC
procedures. The procedures that are
currently included on the ASC list that
the commenters have chosen for
comparison, CPT codes 62287 and
62294, are interventional procedures
and are, therefore, not valid
comparatives for this purpose.