svms
Networker
I am having questions about billing 73562 with 73565. It is confusing.
I bill a lot of 73560 with 73565 with no problems. But I do have difficulty getting payment with 73562. I believe the problem may be an NCCI edit, but I'm not sure.
I found an old AAPC News ( Coding Diagnostic view of the knee Oct 1st 2007) that states "If the standing AP view is performed alone, then you should report code 73565. Medical necessity for one or both of the knees must be demonstrated. If the standing AP view is performed as an additional view and done in conjunction with other views of one side (RT or LT), it is added to the study as an additional view.
For example, if the standing AP view is added to an AP and lateral view (two views), that study becomes a three view study (code 73562). If the standing AP view is added to a four view study, such as an AP, lateral and both obliques, the standing AP is bundled (CCI edits), because code 73564 states that it includes four or more views."
73562 is a column 2 edit. I understand billing 73562 with a modifier 59 with 73565. But according to above paragraph we cannot bill 73565 together with 73562 at all. Is this correct???
Please help me understand this.
Thanks!
I bill a lot of 73560 with 73565 with no problems. But I do have difficulty getting payment with 73562. I believe the problem may be an NCCI edit, but I'm not sure.
I found an old AAPC News ( Coding Diagnostic view of the knee Oct 1st 2007) that states "If the standing AP view is performed alone, then you should report code 73565. Medical necessity for one or both of the knees must be demonstrated. If the standing AP view is performed as an additional view and done in conjunction with other views of one side (RT or LT), it is added to the study as an additional view.
For example, if the standing AP view is added to an AP and lateral view (two views), that study becomes a three view study (code 73562). If the standing AP view is added to a four view study, such as an AP, lateral and both obliques, the standing AP is bundled (CCI edits), because code 73564 states that it includes four or more views."
73562 is a column 2 edit. I understand billing 73562 with a modifier 59 with 73565. But according to above paragraph we cannot bill 73565 together with 73562 at all. Is this correct???
Please help me understand this.
Thanks!