Wiki Bundled Services on Claims

[SUEV]

If Medicare considers a code bundled into something else, are we supposed to put it on the claim anyway? I'm confused because CMS will always deny code 95992 but states physicians should use this code for the canalith repositioning. So, am I supposed to bill it every time and always get denied or can I just not bill it? We don't unbundle surgeries but is this different? Here's the article that discusses CMS' position on this:

www.cms.hhs.gov/MLNMattersArticles/downloads/MM6407.pdf

 

[LLovett]

That is a bit confusing.

My take on that is that you would not report that code at all. The reason they are saying providers must use that code for that service I believe is to indicate you can't try and bill it as something else.

Just my take on it, I don't actually bill for that so hopefully someone who does will respond to you as well.

Laura, CPC, CEMC

 

[jthweatt]

I read the notice as "physician, use code 95992 but we will not pay you", but "therapists, use code 97112 and we will pay you." So, no we do not bill Medicare for the Epley (95992).