Wiki help with 29877

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I bill for both ASC & physician, is it true when dr. performs let's say for example, a medial menisectomy 29881 & a lateral compartment chondroplasty 29877-59, only the physician can bill for the chondroplasty & not the ASC, the ASC can only bill for 29881 is that correct?

thanks
 
My experience with this situation is, when 29881 is performed with chrondroplasty the facility would bill 29881 the physician would bill 29881 with G0289.
 
I'm just trying to find out where is this written somewhere that the facility can't bill for chondroplasty, where as in the past they were able to
 
Depending on your contracts...

ORTHO Coding Alert Vol 11, #11 2008

An article in Orthopedic Coding Alert Vol. 11, No. 6, "Replace 29877 With G0289 for Smooth Sailing," should have stated that ASCs should not report packaged procedure G0289. Per CMS, "ASCs should not report separate line item HCPCS codes or charges for procedures, services, drugs, devices or supplies that are packaged into payment for covered surgical procedures and therefore not paid separately" (www.cms.hhs.gov/ASCPayment/downloads/ASC_QAs_03072008.pdf).
 
We bill 29881 & 29877 on our ASC claims and get reimbursed on both codes just fine. In Washington we only need to change 29877 to G0289 on our Medicare and Regence claims. I recommend you contact your Provider Relations Dept at the insurances that are not reimbursing you. They can be very helpful.
 
I agree with Meggett. The chrondroplasty (29877) can be billed to carriers other than Medicare (or medicare products).

And I agree with Jamie in that the G0289 should not be billed to Medicare as is the case with any procedures with the N1 payment indictator.

Mary, CPC, COSC
 
thank you guys,


I kept being told that the chondroplasty really represents just physician work, & that the ASC can't bill for it, I saw read an article in Becker's ASC Review "ASC claims matching: A Practical Guidance to ensure fair reimbursement" stating how both physician & ASC should match in CPT codes

"It's also important to know that there are a few times when the claims are not supposed to match. For example, consider a case where a surgeon performs an arthroscopic medial meniscectomy and an arthroscopic chondroplasty in the lateral compartment of the knee. the facility should report CPT code 29881 while the surgeon would report a 29881 as well as a Go289 or 29877 for the condroplasty, depending on the carrier"

So I started to wonder why didn't they mention that the facility should bill both 29881 & 29877
 
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