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CPT code 33249 and 33225

  1. Default CPT code 33249 and 33225
    Medical Coding Books
    Hi all. Hope someone can answer this. I have recently been given a report to make sure that certain services are being processed correctly and was questioning the way the 33225 was being processed when billed in conjunction with the 33249.
    The Insurance Company in question is allowing 50% of the 33225 when billed on the same day as the 33249. They are allowing 100% for the 33249.
    Now, when I look at their fee schedule for the 33225, there is nothing in the 'mult proc' column and when I look at the National Physician Fee Schedule, there is a 'zero' in the 'mult proc' column.
    However, when I look at the 33249, there is a 'yes' in the 'mult proc' column and a 1 in the National Physician Fee Schedule 'mult proc' column.
    This may be a stupid question, but when there is a 1 or 'yes' in only one of these columns, does it still mean that the multiple procedure rule should apply??

  2. Default
    I should probably add that I am billing for the physician from a private office and the services were done at the hospital.

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