Leorah Posted Sat 21st of January, 2017 13:24:59 PM
Is multiple surgery discounts just a CMS rule or is it included in the AMA code description as well?
SuperCoder Answered Mon 23rd of January, 2017 08:25:49 AM
Leorah Posted Tue 24th of January, 2017 15:40:46 PM
Thanks for the information. The link does not seem to prove that the multiple surgery discount is just a CMS issue. Please advise
SuperCoder Answered Wed 25th of January, 2017 06:25:24 AM
According to CMS, Multiple procedure reductions apply when:
· There are two or more procedure codes subject to reductions. If two codes are billed but only one is subject to reduction, no reduction will be taken for either procedure; both codes are reimbursable at 100% of the allowable amount.
· A single code subject to the multiple procedure concepts when submitted with multiple units. For example, CPT code 22522 is submitted with 3 units. Multiple procedure reductions would apply to the second and third unit.
· The billing of more than one separately payable surgical procedure by the same physician performed on the same patient on the same day, whether on different lines or with a number greater than 1 in the units column on the claim form or inappropriately billed with modifier “-78” (i.e., after the global period has expired)
SuperCoder Answered Wed 25th of January, 2017 07:25:09 AM