Wiki help please - I work for a group

[gray2013]

I work for a group of providers who bring their own equipment to offices for the Novasure and Essure procedures, CPT 58563 mainly, and when billing, we use the professional CPT code, such as 58563 but add modifier TC to show that we are billing for the equipment only. Many payors are paying but some are denying stating invalid procedure code/modifier combination.
Is there another code from HCPCs that we should be using since it's equipment? I know when the ultrasound machine is brought in, we bill the CPT and add modifier TC and there aren't any problems/denials.
Please help if you have any ideas of the correct way to code/bill this equipment.
Thank you.

 

[IndepCoder]

novasure

What type of billing ? ASC Freestanding? Dr Office?

Have you tried DME codes?
Looking up the payer guidelines in writing as to how to bill?

Usually they will have some policy.

Hope this helps

 

[MarcusM]

ugg...my doctor owns his own EMG machine and takes it to hospitals for diagnostic testing. We bill for both the professional interpretation and the technical because the doctor does both the testing with the diagnosis/interpretation. We always add that we own our machine, give the make, model and serial number and document this in the report. The facility bills for use of the room, but since they don't own the equipment, they don't get paid for providing any equipment. Perhaps you, if you are the facility, are bumping up against the providers' billing the whole component. Not sure what the correct solution as the hospital does get paid, but I don't know what CPT codes they use. Good luck with this dilemma.