Wiki G0268

[kcowan]

WE SUBMITTED A CLAIM FOR A BOON CHAPMAN PATIENT FOR OV (99214), 69222, G0268, 92557, AND 92567 EVERYTHING WAS PROCESSED BUT THE G0268 DENIED BUNDLED? WHY WOULDN'T THE G0268 BE COVERED?

 

[sls314]

WE SUBMITTED A CLAIM FOR A BOON CHAPMAN PATIENT FOR OV (99214), 69222, G0268, 92557, AND 92567 EVERYTHING WAS PROCESSED BUT THE G0268 DENIED BUNDLED? WHY WOULDN'T THE G0268 BE COVERED?

NCCI Edit.

G0268 cannot be billed with 69222. A modifier is not allowed to override the relationship.

 

[kcowan]

NCCI Edit.

G0268 cannot be billed with 69222. A modifier is not allowed to override the relationship.

THAT IS WHAT I WAS THINKING

 

[kcowan]

THAT IS WHAT I WAS THINKING

WHERE DID YOU FIND THAT INFORMATION. WE USED TO USE OPTUM 360 BUT WE DON'T HAVE ANYMORE IS THERE SOMEWHERE ELSE I CAN FIND THAT KIND OF INFORMATION?

 

[sls314]

WHERE DID YOU FIND THAT INFORMATION. WE USED TO USE OPTUM 360 BUT WE DON'T HAVE ANYMORE IS THERE SOMEWHERE ELSE I CAN FIND THAT KIND OF INFORMATION?

NCCI is developed by CMS. Sites like Optum pull the PTP edits from CMS anyhow - some of those subscription based interfaces can be user friendly, but you can always get the data straight from the original source:

https://www.cms.gov/ncci-medicare

The PTP (Procedure to Procedure) spreadsheets are what you'll want for this purpose, but there's also a wealth of other info on the CMS NCCI site.