Wiki NCCI or Bundled codes

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ShelleyM

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Can anyone tell me where I can find what place of service a certain code is to be billed? Specifically 67015 postop after 67042.
Thanks!
 
I don't understand the question.. the place of service code corresponds to where the patient is when the service is delivered. It does not depend on the CPT code.
 
Walker is correct you must bill the place of service correct to where the service took place. This is one of the big issues with the OIG this year.
 
Thank you for your replies. I guess I need to be more specific. Someone in my office billed the 67015 as in the office, but I'm thinking that had to be something that was done as outpatient at the hospital. Any thoughts in that regard?
 
If it was performed in office then that is how it must be billed if it is a non allowed place of service 11 procedure, then you will get an edit that indicates the place of service is incorrect for the procedure billed, if that happens then you will need to write it off.
 
If your question is can it be billed during the post op global then again you will need a modifier eith 58, 78, or 79 and the correct place of service. Without the modifier regardless of the place of service then it will bundle into the global.
 
BK2010 said:
Thank you for your replies. I guess I need to be more specific. Someone in my office billed the 67015 as in the office, but I'm thinking that had to be something that was done as outpatient at the hospital. Any thoughts in that regard?
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Per the CMS fee schedule, there isn't a non-facility fee so this tells me it can't--or should I say "shouldn't"-- be performed in POS 11
 
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