Wiki Neurostimulators

[puppymom2]

I am consulting for a doc who tells me his billers tell him he can't bill 64566 unless he does a complete H&P each visit. According to all documentation I can find, Medicare allows 12 weekly treatments. I can't find anything stating you need to do a complete H&P each visit and, quite frankly, this sounds ridiculous to me. Has anyone had a problem getting paid by Medicare for this procedure? Thanks!

 

[bill2doc]

Hi there,

No problems getting paid. We bill the H&P only at the first visit and only during the weekly treatments if the patient needs to be seen for other reasons, we would then append -25 Mod. We do get paid with both H&P and PTNS alone. There has been confusion on the 95971 which we use to bill with the unlisted code. 64566 says "do not report with 64555, 95970-95972" although he had received payment for 95971 w/ 64566. Hope that helps

 

[puppymom2]

Helps a lot, bill2doc! Thanks.