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Fluoro

g.fairchild

Networker
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57
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0
Morning everyone,

Has anyone else having issues getting 77003 paid? It seems it is bundled/incidental to practically every procedure we are doing...any suggestions?

Thanks for the input!
 

RebeccaWoodward*

True Blue
Messages
3,126
Location
North Carolina
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0
Fluoro is bundled into most of our surgical procedures.

5. Fluoroscopy is inherent in many radiological supervision and interpretation procedures. Unless specifically noted, fluoroscopy necessary to complete a radiologic procedure and obtain the necessary permanent radiographic record is included in the radiologic procedure and should not be reported separately

http://www.cms.gov/NationalCorrectCodInitEd/

This is found in the NCCI policy manual link...chapter 9...page 6
 

g.fairchild

Networker
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57
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0
Thanks for the info, I did find what actually pertains to our procedures:

"Many interventional procedures require contrast injections for localization and/or guidance. Unless there are CPT instructions directing the physician to report specific CPT codes for the localization or guidance, the localization or guidance is integral to the interventional procedure and is not separately reportable."

Will read further to see if there is a way around this....
 

RebeccaWoodward*

True Blue
Messages
3,126
Location
North Carolina
Best answers
0
The only way around it is if you are coding 59 mods with the procedures and you can link the flouro to one of the OTHER codes.
If the fluoro is used for the purpose of the surgical procedure, it would not be appropriate to unbundle the service. If audited, you will be asked to refund the money-AND-if the carrier decides to dig deeper and determine a pattern of unbundling, you are a risk for fines and other disciplinary measures.
 
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