Paula Posted Thu 12th of September, 2013 12:02:00 PM
When billing for a physicians office can the contrast Onmipaque Q9966 be submitted to carrier, or is it bundled in the 77003 charge?
IS the bupivacaine bundled into the 62311 code, or is it reportable with J3490? What resource indicates which HCPCS codes are bundled into pain injections?
SuperCoder Answered Fri 13th of September, 2013 08:06:22 AM
The physician’s office may bill the Omnipaque separately assuming the office bears the cost. http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM3902.pdf
Whether the bupivacaine is separately payable depends on the payer. Often it isn’t (see CCI manual and CPT surgical section guidelines for the concept of not separately reporting anesthetic with surgery when done by same physician), but check this example: http://www.cgsmedicare.com/ohb/pubs/mb_J15/2013/08_2013/PDFs/OH_2013_08.pdf
It says: “Allowed when billed with 51700, 51720, 62310, 62311, 62318, 62319, 62368, 64400 - 64484, 64505 -64530, 77003, 95990, or 96530. When billed with other procedures, considered part of procedure performed”