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Perform 63030 & 63056 percutaneously?

  1. Default Perform 63030 & 63056 percutaneously?
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    Vendor says the ASC can bill 63056 and 63030 for doing it percutaneously. He says facilities in the north are doing it alot. It is just now coming to the south (TX).I can see 63030 maybe due to the "endoscopically-assisted" part of the definition, but 63056? Any experience or thoughts on this usage of these codes?-Norma

  2. #2
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    Tacoma, WA
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    Quote Originally Posted by Nciovica View Post
    Vendor says the ASC can bill 63056 and 63030 for doing it percutaneously. He says facilities in the north are doing it alot. It is just now coming to the south (TX).I can see 63030 maybe due to the "endoscopically-assisted" part of the definition, but 63056? Any experience or thoughts on this usage of these codes?-Norma
    I don't trust vendors for correct coding. The Encoder Pro shows both of those codes as not allowable on the ASC list. Sometimes what they are talking about is a different code entirely, but they are trying to get the providers to bill a code that will pay more. Do a lot of research!
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3
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    Having worked with many vendors, I can tell you this is a good place to START! However, do you own research and validate the coding they recommend. When a vendor has told me "physicians or facilities are getting paid for it" I always think two things, "was it paid correctly?" or "just because it got paid, doesn't mean it was processed right, and will the money be requested back at some point?" Start with the vendor documents, look at the source of their info. Good vendor documentation should include the source. I created vendor coding guidance for many products and/or procedures. On ALL of my guidence, the source(s) was included so you could look right where the info was. I have also seen vendor guidance over my years in coding, that had no source and the vendor couldn't/wouldn't tell me what the source was. I have also seen vendor guidance with a source, however, upon further research on my own, I found some of it to be incorrect. Good luck!!
    Machelle Morningstar, CPC, COC, CEMC, COSC
    AHIMA Approved ICD-10-CM/PCS Trainer

  4. Default
    Usually when a vendor says something can be done, I usually always question it. Just because other providers are doing it doesnt mean it is correct. I would not bill 63030 and 63056 if these procedures are done percutaneously. Minimally invasive is different, if the procedures are done using a minimally invasive technique, you could bill 63030 and 63056. The definition of minimally invasive is that you can use assistive devices but it is only considered open if the anatomy being operated on can be seen with the naked eye through the incision. 63030 and 63056 are valued for an open approach not percutaneous.

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