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Thread: Cpt 77003

  1. #1

    Question Cpt 77003

    Hi Everyone,
    Has anyone noticed that when doing interventional pain procedures that in addition to using the 26 modifier for 77003, that they are having to use the 59 modifier too?

    I have been searching for some sort of documentation on this and am coming up blank.

    Any suggestions would be greatly appreciated.

    Connie

  2. #2
    Join Date
    Apr 2007
    Location
    North Carolina
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    3,128

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    Many procedures include fluoro. Unbundling by adding mod. 59 to receive payment is inappropriate if the the fluoro is inherently built into the procedure. I suggest reading CMS' guidelines for proper reporting.

    http://www.cms.gov/NationalCorrectCo...1_overview.asp

    Click on the "NCCI Policy Manual" and open chapter 9

  3. #3
    Join Date
    Apr 2007
    Location
    Sioux Falls South Dakota
    Posts
    358

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    Especially with the facet injections this year - the codes changed 01/01/2010 to include fluoroscopy, when it used to be billed separately. Be sure to check the descriptions of 64490-64495.
    Last edited by cmcgarry; 08-04-2010 at 02:37 PM. Reason: corrected spelling
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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