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63030

  1. #1
    Default 63030
    Medical Coding Books
    We are having a lot of difficulty getting reimbursement on 63030 for HNP. I am unable to locate any information to send to the insurance companies regarding this. I believe in CPT Assistant, Feb 2001, Volume 11, Issue 02 it stated that it could be unbundled but I can not obtain that information. We have adjusted our dx to show instability on all other procedures except 63030 and sometimes this helps. Usually send a letter, Code-X, and Op note. Unfortunately, if they do come back with a payment, they are usually recouping from another line at the same time. Would anyone have any suggestions? Thank you

  2. #2
    Location
    North Carolina
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    Give an example...what other codes are you submitting it with?

  3. #3
    Default
    It is when procedures 22612, 22630-51,22840,22851 are performed together. I have been told by our previous spine coder that if it is for decompression and HNP it can be unbundled and we would be justified for expecting payment. It is causing a great deal of headache with us and AR dpt. Any input and guidance is greatly appreciated!

  4. #4
    Location
    North Carolina
    Posts
    3,126
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    For decompression...yes.

    Can you fax the office note to me...removing any patient data. If so, PM me.

  5. #5
    Location
    North Carolina
    Posts
    3,126
    Default
    Codes 63030 and 63047 are bundled per the NCCI edits with code 22630. CPT Assistant (January 2001) states that these codes can be reported in addition to the fusion code if performed for decompression (apply modifier -59 to the decompression code in this instance).

    Documentation is the key for these type of spinal procedures. The physician has to be very detailed in his dictation.
    Last edited by RebeccaWoodward*; 02-05-2009 at 12:10 PM. Reason: Wrong citation

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