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45393 not recognized by Medicare- Now bill 45378 & G6021?

Kelly Posted Wed 09th of September, 2015 16:37:25 PM

Hello,

I just finished reading an article saying Medicare will not pay 45393. Instead I am now to report 45378 & G6021, see article http://gi.org/wp-content/uploads/2014/12/395-005PNQ_14-6-CPT_Coding_Updates_FINAL.pdf.

Can you please tell me how I do this? Do I put a money value to the G6021 HCPCS code? Do I add a note to the code? Also, how do I calculate RVUs for this service as a whole now?

Thank you!

SuperCoder Answered Thu 10th of September, 2015 00:34:50 AM

I am not getting anywhere that medicare will not pay CPT 45393. CPT 45393 is effective from 1st Jan. 2015. But it cannot be billed with CPT 45378. Also, do not report 45393 more than once per session. Furthermore, Medicare physician fee schedule do not mentioned any facility/non-facility and Work RVU. Kindly confirm it with your payer.

Kelly Posted Thu 10th of September, 2015 20:59:49 PM

When I check the fees on your website for my area (rest of Pennsylvania 99) there is no reimbursement for this CPT code. Any help?

SuperCoder Answered Fri 11th of September, 2015 01:13:36 AM

CMS has not provided the facility/non-facility and Work RVU. Kindly confirm it with medicare or your insurance carrier.

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