TAP questions/bundled 64486-64489

[traceystewart]

If anesthesiologist placed 64488 (bilateral, by injection) and also 64487 (by continuous infusion on the right side only) can both codes be billed together? Modifier? I'm getting edit stating NCCI edit : 64487 "can never to report together with code 64488 due to CCI mutually exclusive edit? Any help with this would be greatly appreciate

Big thanks to any helpers...Tracey, CPC

 

[dwaldman]

"Code 64488(column 1) has a CCI conflict with code 64487(column 2). A modifier is not allowed to override this relationship."

64487
Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed)

64488 Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed)

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Since modifier is not allowed, 64487 would not be separately reportable for Medicare or carrier that follows NCCI. To put that reimbursement implication in context if 64487 has a Medicare allowable of around $76.26 when reported as a standalone code and since it has the lower RVU than 64488 even if it was not subject to the NCCI edit, it would be at 50% if could of been reported with 64488 so it that is only involving around $38.13 that will not be received from a Medicare perspective.