Wiki 62310/62311 w/ 77003 for Medicaid

[dwaldman]

62310 77003 20150101*1

62311 77003 20150101* 1

http://www.medicaid.gov/Medicaid-CH...stems/National-Correct-Coding-Initiative.html

Medicare had placed in their final rule for 2015 that CPT 77003 could not be separately reportable with epidural codes 62310-62319.


Medicare has now released quarter 2 NCCI edits and they have a coding edits for 62310-62319 with 77003.

Medicaid is required to utilize NCCI when processing claims.

Medicaid has adopted this edit also and it would not be appropriate to report 77003 with 62310-62319 for Medicaid would be my understanding.

 

[Esther04]

I keep searching on my MAC website (Noridian) don't seem to find where they finalized this. Do you know when this will take effect? thank you!

 

[marvelh]

Note that the NCCI bundling edit is retroactive back to Jan 1, 2015, not April 1st.

Practices that have billed Medicare for fluoroscopy with 62310-62319 in 2015, should consider processing a refund for the image guidance. It is likely that the Medicare contractors, CERT and/or ZPIC audits will review for this and do refund requests.

 

[AndieL]

So thankful to have found this thread! I always thought we could bill 77003 separately from the 62310 & 62311 when our physicians were using it for needle guidance during the years 2013 & 2014 no matter what the insurance company. Can someone please tell me if this is true?

 

[shughes6560]

[Federal Register Volume 79, Number 219 (Thursday, November 13, 2014)]
[Rules and Regulations]
[Pages 67547-68010]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-26183]