Wiki Add on codes

[misty.keglor@wellpoint.com]

I have a physician who is advising me there are particular add on codes which should not apply to rate reduction. He stated there are guidelines stating this. Can anyone advise or instruct me to these guidelines if in fact they do exist??

Thanks!

 

[penguins11]

There are a lot of codes that rate reductions do not apply on. Probably the easiest resource to access is to do a search on CMS website for payment policy indicators for the codes you have a question on. There is a category called multiple surgical procedure and the number indicates whether a reduction applies. Also, appendix D and E of the 2011 CPT manual lists all the add on and 51 exempt codes. You should expect 100% reimbursement for all of the codes on this list.