Greetings all: Our pain doc performs discograms frequently.
Example: Three level discogram I would bill to Medicare as
62290
62290-51
62290-51
72295-26
72295-26
72295-26
We are receiving payment for the three levels of 62290 and only one level of 72295. I was told that we should append modifier -59 to the additional 72295 codes. Is this correct? Also, Medicare has now started to ask for refunds for these procedures dating back to 2005, stating the provider was not eligible to bill for these particular procedures.
I am yet to speak with a representative to get clarification. There was some mention of specialty 49 which I understand to be an ASC. These procedure were performed in an ASC. Really confused. Any and all responses will be greatly appreciated.
Thank you,
Michelle
Example: Three level discogram I would bill to Medicare as
62290
62290-51
62290-51
72295-26
72295-26
72295-26
We are receiving payment for the three levels of 62290 and only one level of 72295. I was told that we should append modifier -59 to the additional 72295 codes. Is this correct? Also, Medicare has now started to ask for refunds for these procedures dating back to 2005, stating the provider was not eligible to bill for these particular procedures.
I am yet to speak with a representative to get clarification. There was some mention of specialty 49 which I understand to be an ASC. These procedure were performed in an ASC. Really confused. Any and all responses will be greatly appreciated.
Thank you,
Michelle