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Bundling of procedures

  1. #1
    Location
    Morristown
    Posts
    40
    Default Bundling of procedures
    Medical Coding Books
    If two procedures are performed by two different physicians billing under the same Tax ID, for example CPT 63075 & 95920. Dr X performs 63075 and Dr Y performs 95920, both physician bill under same tax ID. Would CPT 95920 be considered bundled? or can Dr Y also bill seperately?
    Looking for confirmation!
    Thanks

  2. #2
    Default
    Can you not use modifier 62 in a case like this?

  3. #3
    Location
    North Carolina
    Posts
    3,126
    Default
    According to CCI edits, 63075 and 95920 have an bundling indicator of 0. 95920 is bundled into 63075 and can not be overridden with modifier 59.

  4. #4
    Location
    Morristown
    Posts
    40
    Default
    Rebecca, yes they are bundled and and mod 59 is not applicable, the question is does it matter if procedures are done by two different physicians same tax ID, two different reports..... is there anything in writting that I can use?

    Martn mod 62 is not applicable to 95920 and neurophysiology testing was performed after the discectomy.
    Thanks all for your input

  5. Default
    I think you have to bill 63075 for first physician and 95920 for the second without using any modifier.

  6. #6
    Location
    North Carolina
    Posts
    3,126
    Default
    I'll reference CMS' guideline........

    Intraoperative neurophysiology testing (CPT code 95920) should not be reported by the physician performing an operative procedure since it is included in the global package. However, when performed by a different physician during the procedure, it is separately reportable by the second physician. The physician performing an operative procedure should not bill other 90000 neurophysiology testing codes for intraoperative neurophysiology testing (e.g., 92585, 95822, 95860, 95861, 95867, 95868, 95870, 95900, 95904, 95925-95937) since they are also included in the global package.

    Located in Chapter 11

    http://www.cms.hhs.gov/NationalCorrectCodInitEd/

  7. #7
    Location
    Morristown
    Posts
    40
    Default
    Thanks for the feedback

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