Wiki Ortho-Fall Assesment

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Linda77

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We are offering a series of new testing at our Ortho clinic. But I am very confused about the combination of codes used. They are 92540, 92541, 92542, 92543, 92544, 92545 and 92546. Per the instructions these codes can not be billed together but the Dr. spoke with a rep from the company that the equipment was purchased that swears you can. I am feeling very uncomfortable about the combination of codes and I am wondering does anyone have knowledge in this area. Thanks guys your the best! :)
 
According to NCCI edits 92540, 92543 and 92546 have no edits. However 92541, 92542, 92544 and 92545 are all column 2 code to 92540 with a modifier indicator of zero, so no modifiers are allowed with these code combinations.

You may want to show the Dr. the NCCI edits since no sales rep can get around them.
 
Check you CPT book as well, in the 2015 version these codes have new instructions that specifically indicates these cannot be used in conjunction with certain combinations. As indicated by the CCI edits as well.
 
Linda77 said:
We are offering a series of new testing at our Ortho clinic. But I am very confused about the combination of codes used. They are 92540, 92541, 92542, 92543, 92544, 92545 and 92546. Per the instructions these codes can not be billed together but the Dr. spoke with a rep from the company that the equipment was purchased that swears you can. I am feeling very uncomfortable about the combination of codes and I am wondering does anyone have knowledge in this area. Thanks guys your the best! :)
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Thank you for the feedback :) you guys have a great day!!
 
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