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Looking for some feedback on billing TCM and CCM code G0506 together. It’s been brought to our attention that these are denying when billed together. Wondering if a simple -25 modifier would fix or if this isn’t allowed. Can’t seem to find any clear documentation in the guidelines.
Thanks!
Aren’t these paid separate, how do i appeal this being bundled.
Im using 93458/26
75625 26 59
and 75716 26 59
I would like to know if I can code the selective cath placement 36245 with hearth cath. Thank You
I have a record that reflects Smith-Petersen osteotomies taking place at T10-T11, T11-T12, T12-L1, L1-L2. So I have 5 vertebra, 4 interspaces. The CPT description reflects "Vertebral segment", so I’m thinking that I should have a total of 5 units billed total. (T10, T11, T12, L1, and L2)
22214 has an RVU of 43.10.
22212 has an RVU of 42.94.
FIRST QUESTION:
*22214 has the higher RVU, so should the coding reflect 22214 x 1 then 22216 (add-on) x 4?
*Or is it 22214 x 1, 22212-59 x 1, 22216 x 3?
SECOND QUESTION:
Am I correct in 5 units total or is it only counted based on interspaces, even though the code descriptor shows vertebral segment?
Thanks in advance, and if you have anything (links, etc) to support your response I’d greatly appreciate it!
For example:
Right L4-5 TLIF
L3 to L5 posterolateral arthrodesis
I would submit this as:
22633
22614
Should I be using: 22633 and 22612??
Please help!! I appreciate your time.
Patient has a non-maturing AVG. there is significant tortuosity of the cephalic vein, as well as a branch point. Both the main cephalic vein and the accessory cephalic vein were tortuous; the main cephalic was also small and atretic higher in the upper arm.
The doctor resected a significantly kinked portion of vein and performed end-to-end anastomosis, AFTER the anastomosis was finished, an angiogram was done in order to determine which branch of the cephalic vein was more suitable for dialysis (see findings above), and to choose which tributary to ligate. tributary was ligated, wound was closed.
The Resident billed CPT 99218-GC, POS 22
The Teaching MD billed CPT 99284, POS 23
Are both encounters reimbursable for the same DOS?
Thank you in advance.