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neuroplasty/ fluroscopy

Carlon427

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We have encountered a problem with NUCLEOPLASTY being denied as experimental?? Any suggestions?? Some payers will pay for the fluroscopy only. Any modifer thats can be used? Or should dictation be submitted with each claim?? :confused:
 
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checked into this

Hello, I ran a report in our system for the past year. I didn't see any that we billed with fluroscopy, however I didn't find any denials at all. The only 3 ins classes I see being billed are Medicare, WC and private RMSCO. All three insurances paid the claim within one month without even requesting notes. I checked the first ICD-9 on each of them... they were all billed w/ 722.10 or 722.52

I will try to look for a Local medical review policy on NGS' web site. I know that Healthnow/UMD used to have one, if I can find it I will post the link!
 
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checked into this

I couldn't find the local policy, however I did check my neurosurgery coding companion, it's published by ingenix, it describes the procedure and also shows the NCCI edits associated w/ the code.

it advises the icd-9's associated are 722.10, 722.73, 724.2, 724.4

for fluoroscopic guidance use 77002

CCI's show specific CPT's including diskectomy, kyphoplasty, and some fluoro including 76000-76001 and 77003 you can e-mail me if you need the entire list... RebekahSlackCPC@aol.com

Hope this helps!
 
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