He had a prior billing company that coded the same codes and are :
38205
38207
38208
38212
38214
38215
38240
All were billed on 4 lines. The 1st line was standard CPT code then the following 3 utilized 59 modifier. He should be able to code for these services as the lab/machine prepared the umbilical cord blood into stem cell and was frozen, preserved, thawed etc. Unfortunately the previous billing company informed him he could utilize the same pre-cert/pre-auth as the hospital! I’m not sure how they stay in business.
Does anyone have any information on this fairly new procedure? Obviously it is allogeneic as it is a different donor aka maternal mother!
The other downfall is the "old school" MD did not state how many CC’s/units utilized however it should state 4 cc’s so that is why I am believing they billed a total of 4 units ??
If someone has experience and can lead me to it, I would GREATLY appreciate it.
Thank you