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Thread: new question 63650

  1. #1

    Default new question 63650

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    Thanks for all your previous help with this code.
    My new questions is: We billed 63650 (physician) twice medicare pt. with 58 modifier on both lines and 51 on second. They paid the same amount for both. Does that sound correct????

    Thanks
    Vicki
    CPC

  2. #2
    Join Date
    Apr 2007
    Location
    Athens, Ga.
    Posts
    693

    Default

    yes.. this code is not subject to multiple procedure discounts
    Walker Bachman, CPC, CPPM

  3. #3
    Join Date
    Apr 2007
    Posts
    1,486

    Default

    http://www.cms.gov/pfslookup/02_PFSs...es&next=Accept

    You didn't state if you were billing for the physician or the facility side.

    For the physician side if you use the above link and choose payment indicators for 63650 Under Multiple Surgery Reduction is a indicator of 2

    2 = Standard payment adjustment rules for multiple procedures apply. If procedure is reported on the same day as another procedure with an indicator of 1, 2, or 3, rank the procedures by fee schedule amount and apply the appropriate reduction to this code (100%, 50%, 50%, 50%, 50% and by report). Base the payment on the lower of (a) the actual charge, or (b) the fee schedule amount reduced by the appropriate percentage.

    For the facility side, 51 would not be appended on the claim and you would not see the reduction because they have to cover the cost of each lead in the procedure code.

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