anicole76
New
I am an insurance/coding representative for a Neurosurgical Center and we are receiving conflicting information regarding coding multiple levels of a spinal fusion. We are currently coding them as follows:
22612 X1
22614 X1
22614 X1 -76
22614 X1 -76
We have recently received direction from an outside source that specializes in Neurosurgery that individual line items with modifier -76 is not appropriate for the add-on codes, and it should be:
22612 X1unit
22614 X3 units
After extensive research with our available coding resource websites to no avail, two calls were placed to Medicare for clarification. The first time we were told that the way we are coding is correct...the second time we were told that add-on codes for additional levels of the fusion should be billed with multiple units.
Although payer guidelines vary and we are being reimbursed as/is, our goal is to ensure that we are coding appropriately to prevent a future audit. If anyone has any feedback regarding your experience, or where we could locate documentation for clarification, it would be greatly appreciated. Thank You!![Smile :) :)](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
22612 X1
22614 X1
22614 X1 -76
22614 X1 -76
We have recently received direction from an outside source that specializes in Neurosurgery that individual line items with modifier -76 is not appropriate for the add-on codes, and it should be:
22612 X1unit
22614 X3 units
After extensive research with our available coding resource websites to no avail, two calls were placed to Medicare for clarification. The first time we were told that the way we are coding is correct...the second time we were told that add-on codes for additional levels of the fusion should be billed with multiple units.
Although payer guidelines vary and we are being reimbursed as/is, our goal is to ensure that we are coding appropriately to prevent a future audit. If anyone has any feedback regarding your experience, or where we could locate documentation for clarification, it would be greatly appreciated. Thank You!