Melissa*Ever*Evolving
Networker
Hello,
I am needing opinions in regards to the ultrasound guidance (76942) billed in conjunction with TAP blocks (64486-8).
This is an NCCI edit of "1" - included normally but may be unbundled with a modifier when applicable.
Modifier -59 would be used to unbundle and this is to represent, separate site, separate encounter, separate provider, or other unusual non-overlapping service.
There is no qualifying the use of the modifier -59 because this is used specifically for the blocks.
The provider is interpreting this as:
Interpretation of the image should be separately billable with modifier -26. The use of the machine and providing the service is bundled in with the block code, but providing the image interpretation would still be separate.
Do you agree with billing this separately based on the above provider's interpretation?
64488(-59 because being billed as post-op pain management to anesthesia case)
76942-26-59
Please help with this interpretation of the codes. We are trying to remain compliant, but we also do not want to leave money on the table.
Thank you in advance for your thoughts.
~Melissa, CPC
I am needing opinions in regards to the ultrasound guidance (76942) billed in conjunction with TAP blocks (64486-8).
This is an NCCI edit of "1" - included normally but may be unbundled with a modifier when applicable.
Modifier -59 would be used to unbundle and this is to represent, separate site, separate encounter, separate provider, or other unusual non-overlapping service.
There is no qualifying the use of the modifier -59 because this is used specifically for the blocks.
The provider is interpreting this as:
Interpretation of the image should be separately billable with modifier -26. The use of the machine and providing the service is bundled in with the block code, but providing the image interpretation would still be separate.
Do you agree with billing this separately based on the above provider's interpretation?
64488(-59 because being billed as post-op pain management to anesthesia case)
76942-26-59
Please help with this interpretation of the codes. We are trying to remain compliant, but we also do not want to leave money on the table.
Thank you in advance for your thoughts.
~Melissa, CPC