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Oxford - G0289

  1. #1
    Location
    Long Island/New York
    Posts
    1,271
    Default Oxford - G0289
    Medical Coding Books
    Is Oxford ONLY accepting G0289 rather than 29877 as per CMS as I have been receiving more 29877 denials recently and I do not see anything on their website re: this possible change. Thanks.

  2. Default
    I bill G0289 for ALL insurances when billed with another procedure.
    I bill 29877 ONLY when done alone.

  3. #3
    Location
    Long Island/New York
    Posts
    1,271
    Question
    Quote Originally Posted by Bella Cullen View Post
    I bill G0289 for ALL insurances when billed with another procedure.
    I bill 29877 ONLY when done alone.
    don't you lose revenue as G0289 is a lesser RVU/reimbursement than 29877.

  4. #4
    Location
    Columbia, MO
    Posts
    12,527
    Default
    29877 is bundled and is nonmodifiable with most other arthroscopic knee procedures so you may use only the G0289 and only when documentation support the chondroplasty is performed in a separate compartment.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Default
    Not all insurance companies accept G0289 and we still bill 29877-59 to quite a few insurance companies.
    My guess is if you are billing 29877 with a 59 modifier and they deny as unbundling or per CCI edits then they are wanting G0289.
    I have had the account reps in my office get it in writing from a provider rep at the insurance companies that have requested we use it, but have no policy posted on their website. And have also used that in contract negotiations the next year and got one insurance company to allow us to bill 29877.

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