Wiki 29999 vs 64718 HELP PLEASE!!!!

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bbwixler

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PLEASE HELP:confused:

Our facility has been getting alot of cases lately which are Endoscopic Cubital Tunnel Release, which there is no specific procedure code for these to be done, so in turn they are coded with a 29999. Medicare will not pay for the unlisted procedures. Is the facility able to bill a 64718 instead of the 29999 even though the procedure code 64718 is an "open" cubital tunnel release??
 
It is incorrect to use an "Open" approach CPT code for an endoscopic procedure performed. Unfortunately, you are stuck with 29999 using the 29848 as a "like" code or comparable code.
 
It has been my experience that Medicare will indeed pay for unlisted codes, you will have to jump through hoops though. You will need to send the claim and indicate in the electronic equivelent of box 19 that you have additional information to submit. They will then ask for that information. At that time you will need to submit your OP note and a letter stating that this correlates to the open procedure and is more/less difficult and what reimbursement you would like for this service. Each Medicare carrier is different so the process for yours may vary slightly from this. Still, they are likely to pay but you will have to go through the effort.
 
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