Wiki neuro sx

[cooper1]

I didn't see a forum for neuro sx so asking on here. I have a pt who had a laminectomy bilateral on levels L2-3, L3-4, and L4-5. Medicare denied for units. Codes used were 63042 and 63044 can someone please help with how to bill out all the levels and bilaterally?

TIA

Tracey

 

[RebeccaWoodward*]

I didn't see a forum for neuro sx so asking on here. I have a pt who had a laminectomy bilateral on levels L2-3, L3-4, and L4-5. Medicare denied for units. Codes used were 63042 and 63044 can someone please help with how to bill out all the levels and bilaterally?

TIA

Tracey

63042-50 L2-L3 (1 unit)
63044-50 L3-L4 (1 unit)
63044-50 L4-L5 (1 unit)

Is this how you billed it?

 

[cooper1]

No the coder for that coded it as 63042-50 with 2 units and 63044-50 with 4 units as our system doesn't increase the fee and doesn't allow the L2-3 in our system.

So I guess we need to have our employees who post to increase the fee when entering the charges but what do we do about not having L2-3 ect in our system?

 

[RebeccaWoodward*]

What do you mean..."doesn't allow the L2-3 in our system"?

When posting bilateral procedures, we manually double the fee for each procedure.

 

[cooper1]

Do u add L3-4 and L4-5 onto your claim?

 

[RebeccaWoodward*]

Ohhh...I think I see what you're saying. No. I don't add the actual levels (L1-L2) to the claim. I was only showing you what CPT code went with each level. You'll just enter...


63042-50
63044-50
63044-50

One thing I want to mention...Some of my carriers deny the 3rd level as a duplicate. For those carriers that I know are a problem for this, I add 59 also. So...You may have some that request:

63042-50
63044-50
63044-50/59

It should be self explanatory that the 3rd level is an additional level but, for whatever reason, they need things simplified for them.