Wiki Cpt 77003

[scottc1]

Hi Everyone,
Has anyone noticed that when doing interventional pain procedures that in addition to using the 26 modifier for 77003, that they are having to use the 59 modifier too?

I have been searching for some sort of documentation on this and am coming up blank.

Any suggestions would be greatly appreciated.

Connie

 

[RebeccaWoodward*]

Many procedures include fluoro. Unbundling by adding mod. 59 to receive payment is inappropriate if the the fluoro is inherently built into the procedure. I suggest reading CMS' guidelines for proper reporting.

http://www.cms.gov/NationalCorrectCodInitEd/01_overview.asp

Click on the "NCCI Policy Manual" and open chapter 9

 

[cmcgarry]

Especially with the facet injections this year - the codes changed 01/01/2010 to include fluoroscopy, when it used to be billed separately. Be sure to check the descriptions of 64490-64495.