We have a patient. Dr. did surgery on his hand for neurolysis and tenolysis months after a crush injury for numbness and contractures, etc. During this surgery, he did carpal tunnel release, guyon canal release, and neuroylsis of common digital nerve. He basically ran up from starting at the carpal tunnel release on the median nerve at the wrist, followed up the ulnar nerve from there to some adhesions, freed them and then back tracked down the ulnar nerve to the guyon canal release in the hand
My question is regarding the bundling and RVUs. Putting them into encoder, I get back 64721 bundles into 64704 but a modifier is allowed to unbundle.
64721 - RVU 12.54 (bundles into 64704) (neuroplasty medican nerve at carpal tunnel)
64704 - RVU 9.26 (neuroplasty; nerve of hand or foot)
Here's questions I have. I looked and couldn't find any answers that really I felt applied.
Since these are the same incision, but different nerves, I wonder if a modifier is allowed?
Why is something with over 3 RVUs more bundling into a procedure with less? The Medicare fees are about $100 different with 64721 being the weightier of the two. Is it wrong to leave off the 64704 and bill just the 64721? It seems to me as though it is fraudulent, but procedures are being billed under the code with the least amount, and our doctor did the work. I just don't feel it's right that he's getting punished and forced to bill the lowest paying code that is also the most vague of the 3 procedurally. 64704 has a MUE of 2 but since it was all the same ulnar nerve released at 2 spots, it would only bill as one.
Clear as mud? Basically, why would a code worth more, bundle into something worth less.
My question is regarding the bundling and RVUs. Putting them into encoder, I get back 64721 bundles into 64704 but a modifier is allowed to unbundle.
64721 - RVU 12.54 (bundles into 64704) (neuroplasty medican nerve at carpal tunnel)
64704 - RVU 9.26 (neuroplasty; nerve of hand or foot)
Here's questions I have. I looked and couldn't find any answers that really I felt applied.
Since these are the same incision, but different nerves, I wonder if a modifier is allowed?
Why is something with over 3 RVUs more bundling into a procedure with less? The Medicare fees are about $100 different with 64721 being the weightier of the two. Is it wrong to leave off the 64704 and bill just the 64721? It seems to me as though it is fraudulent, but procedures are being billed under the code with the least amount, and our doctor did the work. I just don't feel it's right that he's getting punished and forced to bill the lowest paying code that is also the most vague of the 3 procedurally. 64704 has a MUE of 2 but since it was all the same ulnar nerve released at 2 spots, it would only bill as one.
Clear as mud? Basically, why would a code worth more, bundle into something worth less.