Wiki reimb for add-on code

[KDCOWGIRL]

I am billing for an ASC. I am billing 19301 with add-on code 19297. The Medicare reimbursement for 19297 is higher than the reimbursement for 19301. Will Medicare pay 19297 at 100% and 19301 at 50% even though 19297 is an add-on code? Or will they pay 19301 at 100% and 19297 at 50%? Thanks for any help.

 

[OCD_coder]

Add-on codes typically have a ZZZ indicator per the Medicare fee schedule. This means they are not subject to the multiple procedure reduction rule and they will pay at 100% as they do not include the preop and postop care that the primary code is reimbursed for.