hstefani
Contributor
Recently it was brought to our attention by Medicare that we have been coding Cystocele/Rectocele incorrectly. We are not 100% with Medicare’s decision but are unable to find any thing to the contrary. Here is the scenario:
The OB physician and the Urology physician go in as Co-surgeons. One does the Cystocele, completes the procedure and leaves. The other then begins the Rectocele, completes the procedure and leaves. They are not assisting with each others procedure, they are doing their own separate procedure. Therefore, one provider bills 57240-62 & the other bills 57250-62. However, Medicare says this is unbundling procedure 57260. Is it considered unbundling when it is two different specialties?
The description for 57260 says "combined anteroposterior colporrhaphy" stating the physician does both the cysto & recto but it does not specify two different physicians. I cannot find where it says two different specialties cannot bill each procedure separate. Can any one help me with this?
The OB physician and the Urology physician go in as Co-surgeons. One does the Cystocele, completes the procedure and leaves. The other then begins the Rectocele, completes the procedure and leaves. They are not assisting with each others procedure, they are doing their own separate procedure. Therefore, one provider bills 57240-62 & the other bills 57250-62. However, Medicare says this is unbundling procedure 57260. Is it considered unbundling when it is two different specialties?
The description for 57260 says "combined anteroposterior colporrhaphy" stating the physician does both the cysto & recto but it does not specify two different physicians. I cannot find where it says two different specialties cannot bill each procedure separate. Can any one help me with this?
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