# Add on codes with N1 payment indicator in an ASC



## trichards139 (Mar 29, 2019)

If anyone can help me with this question I would very much appreciate it!!

Is it right or wrong to bill the add-on codes that have an N1 payment indicator for the ASC to Medicare?  Good example is 64490 which is paid at a higher rate because the additional levels, 64491 & 64492 are included in the "package" rate for 64490.

Does anyone else bill the additional levels even though they won't get paid?  I have read that you should bill them for future rate calculations and I've also read that Medicare does not want them billed.  I feel it is not unbundling because they are add-on codes and some commercial payers do pay.

  Thanks everyone!


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## thomas7331 (Mar 29, 2019)

You should bill the add-on codes unless your payer contract or policy specifies otherwise.  The N1 status indicator is a reimbursement policy indicator that gives an instruction on how payment is to be made; it is not a bundling denial, nor is it a coding rule.  The surgeries should be coded according to correct coding guidelines.  I could be wrong, but I have never read anywhere that Medicare 'does not want' these codes to be billed.


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## trichards139 (Apr 2, 2019)

Thank you so much


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