Wiki MUE for fluoro

[jmcpolin]

There is some confusion in our office on whether to bill 77002 when performing bilateral injections in the knee 20610, we understand that MUE edits state to bill only once but Medicare is the one payor that has been paying for both.

 

[dwaldman]

3. CPT codes 76942, 77002, 77003, 77012, and 77021 describe radiologic guidance for needle placement by different modalities. CMS payment policy allows one unit of service for any of these codes at a single patient encounter regardless of the number of needle placements performed. The unit of service for these codes is the patient encounter, not number of lesions, number of aspirations, number of biopsies, number of injections, or number of localizations.

Above is from NCCI Policy manual.

CHAP9-CPTcodes70000-79999_01012012final.doc
Revision Date: 1/1/2012
CHAPTER IX
RADIOLOGY SERVICES
CPT CODES 70000 - 79999
FOR
NATIONAL CORRECT CODING INITIATIVE POLICY

 

[jmcpolin]

Thats what I thought but for some reason Medicare is the only one paying both of them all of our commercial insurance companies are denying the second one.

 

[nlbarnes]

Was this policy in effect prior to 01/01/12?

 

[dwaldman]

Yes, it was in the NCCI policy manual prior to 2012.