Wiki 92133 and 92134 - our NGS policy

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lriesser

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Hi, I am hoping someone can help me out with this question. Per CPT 92133 and 92134 should not be reported at the same patient encounter. But if the provider performs both of them, how do we know which one to bill? There is nothing in our NGS policy that says you have to bill one or the other - do we just chose which one we want to bill then? I am trying to create a policy so that our billing is consistent throughout the department and I cannot find direction that says, bill 92133 or bill 92134. Any help would be appreciated! :confused:
 
92133 and 92134

The doctor would have to tell you which one to bill one is anterior and one is posterior and one is the retina and would you not bill with a modifier to distinguish that it is another procedure done by the same physician...
 
I have found that Anthem will pay for both with a modifier but Medicare will not. I bill the one with the highest charge.
 
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