I need some help with the 76000 code. A doctor uses fluoroscopic guidance for a procedure and Medicare guidelines state that the 76000 code should not be billed with a procedure. The doctor is fighting back stating it doesn't matter if it's a guideline, because of the fact that their Code-X program states that it can be billed and not bundled. Should I be billing that code?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki 76000
- Thread starter kristinab
- Start date
RebeccaWoodward*
True Blue
When it comes to Medicare patients, Medicare guidelines supersede any "coding product"...my opinion, of course. Direct your physician to this particular NCCI edit for the "70000" code section. Per CMS....(page 6)
"Many interventional procedures require contrast injections for localization and/or guidance. Unless there are CPT instructions directing the physician to report specific CPT codes for the localization or guidance, the localization or guidance is integral to the interventional procedure and is not separately reportable."
http://www.cms.hhs.gov/NationalCorrectCodInitEd/
Select the "NCCI Policy Manual" link....open up chapter 9
"Many interventional procedures require contrast injections for localization and/or guidance. Unless there are CPT instructions directing the physician to report specific CPT codes for the localization or guidance, the localization or guidance is integral to the interventional procedure and is not separately reportable."
http://www.cms.hhs.gov/NationalCorrectCodInitEd/
Select the "NCCI Policy Manual" link....open up chapter 9