UCPGCODERS Posted Tue 12th of May, 2015 10:38:26 AM
We are trying to understand the CCI "Misuse of column two code with column one code" edit with 36620 and new transversus abdominis plane (TAP) CPT codes 64486-9. Our anesthesiologists are performing TAP blocks for post-op pain. The blocks are bundled with anesthesia procedure codes, but a modifier override is allowed. However, the bundle with 36620 does not allow a modifier override. So if we provide an arterial line and anesthesia during a surgical procedure and later in the day, provide a TAP block, we are not reimbursed for the block, even with the 59 modifier. Can you provide any rationale for the edit?
Diane Welsh, CPC
SuperCoder Answered Wed 13th of May, 2015 02:37:20 AM
As of now, nothing can be done in this scenario. As per NCCI Code 64486 is a column 2 code for 36620, These codes cannot be billed together in any circumstances. However, NCCI has agreed there is a loop hole in this and they will be making changes which will be reflected in July 1, 2015 update. You can resubmit any denied claims after that date.