Wiki ASC G0260/77002

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KoBee

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Hello everyone -

Our practice codes and bills for our surgery centers (ASC) in UB and 1500, billing dept has been getting denials for CPT 77002 as bundled on UB. But LCD for G0260 states " For ASC facility claims only: G0260 must be billed with fluoroscopy (77002) or CT (77012)".


So should our billing dept not be billing CPT 77002 or should we at least have it on the claim with $0.00. Confused, but i would like to know if anyone else is getting these billing concerns and how can I help our billing dept or are we interpreting the guidelines incorrect.

Appreciate any help.
 
I read that recently also. We have never billed the 77002 with the G0260 code. I have been tracking our claims with this code, Medicare has not denied claims for not having the 77002 code on the claim. We are getting paid for claims with just G0260 billed. Not sure why!
Hope this helps.
 
KoBee said:
Hello everyone -

Our practice codes and bills for our surgery centers (ASC) in UB and 1500, billing dept has been getting denials for CPT 77002 as bundled on UB. But LCD for G0260 states " For ASC facility claims only: G0260 must be billed with fluoroscopy (77002) or CT (77012)".


So should our billing dept not be billing CPT 77002 or should we at least have it on the claim with $0.00. Confused, but i would like to know if anyone else is getting these billing concerns and how can I help our billing dept or are we interpreting the guidelines incorrect.

Appreciate any help.
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We are getting denials. I contacted our contractor and they reviewed our claims and indicated their was a glinch in how they had set up the LCD to process the claims, so my claims were getting denied. They are fixing the edit that caused the denials and are doing a mass reprocess this month for us. I am still waiting for payment!
 
We are having the same issue with our ASC billing. We have called multiple times and at this point there is not fix. We are also in Idaho. Has anyone heard of an update? Has anybody got paid?
 
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