Wiki FACET QUESTION IN ASC - need clarification

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Justarose

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I am being told one thing that makes no sense to me ..and yet what I am reading from AAPC still makes no sense :confused:

example : if done bilaterally ??
New codes 64493,64494,64495

I am told not to bill more than three lines ! ever

But that just does not seem right - what if they are bilateral ?
(still told not to bill more than 3 lines )

Yet what I am reading says this " the new codes have a different code for each level billed (1st - 3rd)
The last code *64495* or *64492* is for the 3rd LEVEL and those codes state the code "cannot be billed more than once per day", which in CPT rules means that only a maxium of 3 levels are allowed to be billed."

What is the "once per day rule" applying to ? The last code only ? or all three?

If 4 levels were done Bilaterally is this correct ??
64490RT
64490LT
64491RT
64491LT
64492RT ( only once ? )

Only THREE levels would be billed by doing this ...right ?

OR

64490RT
64491LT
94492RT

Please clarify this for me ... I feel that the second way is just not right ?

Thanks in advance!
 
ASC billing only...

Three levels bilateral for commercial insurance:
64490-50
64491-50
64492-50

Three levels bilateral for Medicare:
64490-RT
64490-LT
64491-RT
64491-LT
64492-RT
64492-LT

If a 4th level is done, you do not bill for it because 64492 includes payment for the third level AND any additional levels.
 
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