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ASC- 59 VS 76 ON SUBSEQUENT RF CODES

Allison Posted Wed 06th of November, 2013 11:50:25 AM

We are an ASC and have a pain management physician performing radiofrequency in our facility. The physician believes we are wrong to bill 64635 RT and 64636 RT 64636 RT 59 64636 RT 59 and believes we should be billing the subsequent 64636 RT 76 instead. This is due to a coding update from 07/01/13 regarding 59 modifier. Is 59 still applicable for our ASC and the doctor should use 76?

SuperCoder Answered Wed 06th of November, 2013 14:19:57 PM

The correct way to bill these is:
64635 RT
64636 RT
64636-59 or basically how you are billing it now. Use -59 not 76 unless you can find that in writing that the modifier used should now be -76. We have not seen that.

Allison Posted Thu 06th of February, 2014 16:00:52 PM

Please note that Medicare (FL LOCAL 99) as of Jan 1 2014 has been rejecting additional levels completely for 64636 CPT and 64494 CPT. Medical referred to MLN article MM6184 which points to 2014 there is no ASC payment indicator listing for subsequent levels. It shows in FCSO as having a "fee schedule" but the indicator is blank within the spreadsheet on CMS.

SuperCoder Answered Thu 06th of February, 2014 18:16:28 PM

Thanks for the info provided.

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