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PRIMARY 360 FUSION CONFUSION

Terri Posted Fri 15th of March, 2019 14:03:49 PM
WE ARE BILLING THIS PROCEDURE AND GETTING DENIALS. ARE WE OVERLOOKING SOMETHING? 63047, 63048- 59, 22612, 22614, 22633, 22364, 22842, 22853, 22853-51, 20936, 20931, 38222, 77003-26, 95925, 95926, 95937 X 6 THANK YOU.
SuperCoder Answered Mon 18th of March, 2019 07:25:06 AM

Hi,

Thanks for your question.

  1. Code 22612 is a column 2 code for 22633, These codes cannot be billed together in any circumstances. Code 22612 is bundled into code 22633 Code 22612 cannot be billed with 22633.
  2. Code 63047 is a column 2 code for 22633 , but a modifier is allowed in order to differentiate between the services provided. Use modifier with code 63047. CCI edit Rule: Misuse of column two code with column one code.
  3. Code 63047 is a column 2 code for 22634 , but a modifier is allowed in order to differentiate between the services provided. Use modifier with code 63047. CCI edit Rule: Standards of medical / surgical practice.
  4. Code 38222 is column 2 code for multiple codes. These codes cannot be billed together in any circumstances. 
  5. Code 95925 is column 2 code for multiple codes. These codes cannot be billed together in any circumstances.
  6. Code 95926 is column 2 code for multiple codes. These codes cannot be billed together in any circumstances.
  7. Code 95927 is column 2 code for multiple codes. These codes cannot be billed together in any circumstances.

Hope this helps.

Thanks.

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