crice01
New
When a provider orders the following:
Right knee series includes bilateral AP, Bilateral weight bearing PA, lateral and bilateral Merchant views ordered and obtained.
What would the proper billing be? The way I understand it is the physician is looking at 3 views of the affected knee, 2 of the unaffected knee and then the Bilateral standing. Most insurance do not pay for the unaffected side as comparisons so would
73565
73562-rt-59
be appropriate? It has been shown to me that NCCI edits do not bundle these two codes and that 73562 is allowed with 73565 with modifiers.
Or would it be best to code
73564
I am finding quite a bit of conflicting information and most of the sources are from old dates, so I'm asking for advice, there seem to be quite a few payers who are denying then an appeal has to be done (not very many turn out in favor) some payers request records and sometimes pays and sometimes won't pay.
Right knee series includes bilateral AP, Bilateral weight bearing PA, lateral and bilateral Merchant views ordered and obtained.
What would the proper billing be? The way I understand it is the physician is looking at 3 views of the affected knee, 2 of the unaffected knee and then the Bilateral standing. Most insurance do not pay for the unaffected side as comparisons so would
73565
73562-rt-59
be appropriate? It has been shown to me that NCCI edits do not bundle these two codes and that 73562 is allowed with 73565 with modifiers.
Or would it be best to code
73564
I am finding quite a bit of conflicting information and most of the sources are from old dates, so I'm asking for advice, there seem to be quite a few payers who are denying then an appeal has to be done (not very many turn out in favor) some payers request records and sometimes pays and sometimes won't pay.
