medicare bundling 92012 and 92020

[cpccoder2008]

I have been receiving denials from medicare for 92012 and 92020 saying that 92012 is bundled with 92020. It the CPT book it clearly states 92020 is a seperate procedure. Anyone else having this problem ? Thanks

 

[vpcats]

I have been receiving denials from medicare for 92012 and 92020 saying that 92012 is bundled with 92020. It the CPT book it clearly states 92020 is a seperate procedure. Anyone else having this problem ? Thanks

The "separate procedure" clause means that that code is included (bundled) with another code. You'd have to check your CCI to see if 92020 is actually on the list and bundled with the 92012. Check in both directions with each code against each column I and column II. Then also check against the mutually exclusive list.

I don't know what the allowed amounts are for either code but I think they should be paying for the exam and bundling the gonio, not vice versa.

 

[cpccoder2008]

The "separate procedure" clause means that that code is included (bundled) with another code. You'd have to check your CCI to see if 92020 is actually on the list and bundled with the 92012. Check in both directions with each code against each column I and column II. Then also check against the mutually exclusive list.

I don't know what the allowed amounts are for either code but I think they should be paying for the exam and bundling the gonio, not vice versa.

I agree, but i guess they will pay the less out of the two and deny the other, i checked both ways and they aren't bundled. In the coding companion it states if 92020 is performed along with another procedure to attach -59 but i haven't done that before.. Strange !