Wiki 76000-Under what circumstance

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mg65

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Under what circumstance would you use a 59 mod to add a 76000 to a 52332( or other procedure it is bundled into)? The guidelines say if it is justified, but what would have to be documumented to justify it?

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http://www.cms.gov/Medicare/Coding/...ndex.html?redirect=/nationalcorrectcodinited/
This is the link to where you can view or download the NCCI manual (scroll down to "downloads" and select the zip file NCCI Policy Manual for Medicare Services - Effective January 1, 2013 [ZIP, 696KB] )

In chapter 7 and also chaper 9 of the manual it states that fluoro is inherent to the procedures. They give you leeway to bill for fluoro with a modifier if it is separate and apart from the procedure-in your case cysto/stent. Fluoro is bundled/inherent to so many procedures that billing it is more rare than it is common. Hope this helps!
 
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