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ASC BILLING PAIN MANAGEMENT ADDITIONAL LEVELS

Pauline Posted Fri 21st of February, 2014 19:13:35 PM

HOW DO YOU RECOMEND WE BILL OUT THE ADDITIONAL LEVELS WITH OUT SENDING A RED FLAG? WHAT MODIFIERS?

User id : 16255Posted 1 week ago #

'64633' '64634' Are now considered "bundled" codes by Medicare for ASC billing. Should we still be billing the additional levels for these codes (as well as the facet and transforaminals) and the appropriate modifiers? Or should we continue to bill all levels as we have done in the past?

SuperCoderPosted 1 week ago #

This seems a bit strange to me because the codes you say are bundled are for the same type of destruction/injection -- the original injection and "each additional." I've not found any real answers so have sent it to my CE for help. I'll let you know when she responds.

SuperCoderPosted 1 week ago #

The codes now have a status indicator of "N1" in Addendum AA. The practice should still report the additional levels -- they just won't be paid anything for them under Medicare.

SuperCoder Answered Thu 27th of February, 2014 23:16:49 PM

I'm not sure about this, so will have to check with my CE. She'll hopefully get a response back to us soon.

Pauline Posted Thu 13th of March, 2014 18:38:27 PM

ANY NEWS ON THIS???

SuperCoder Answered Thu 20th of March, 2014 10:29:52 AM

Please give us an example of how they used to report the situation and what codes/modifiers you think should report now. My CE requires enough detail to base an answer on.

Thanks,

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