Bundling 64483 and 77003?

[knoxdoc]

My billing employee let me know that she is getting denials for 77003 anytime it is paired with 64483 (L TFESI). She has had no problems with 62311 (L ILESI) and 77003. Only Medicare is still paying without a problem. Insurance companies are (mis)quoting some statement in the cpt manual. Any one else running into this?

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[stim4u]

only seen denials for 77003 with 62310/11 codes by WC. It takes for ever to argue with the wc carriers. Otherwise, aetna is limiting to one 77003 per day, no matter what spinal level you are working on.

 

[Jcm800]

My billing employee let me know that she is getting denials for 77003 anytime it is paired with 64483 (L TFESI). She has had no problems with 62311 (L ILESI) and 77003. Only Medicare is still paying without a problem. Insurance companies are (mis)quoting some statement in the cpt manual. Any one else running into this?

This is news to me. I doubt it is a LCD issue. Something sounds screwy.

 

[wscott]

"This is another claim where we are billing 64493 with 77003. The description of 64493 states that fluroscopy or CT guidance is included with this procedure. We cannot bill seperately for the guidance. I will remove the 77003charges."

I just got this email forwarded to me from my hospitals billing dept via office manager. I'll have to look into this, but apparently we're having an issue too. Anybody have some insight?

 

[Jcm800]

"This is another claim where we are billing 64493 with 77003. The description of 64493 states that fluroscopy or CT guidance is included with this procedure. We cannot bill seperately for the guidance. I will remove the 77003charges."

I just got this email forwarded to me from my hospitals billing dept via office manager. I'll have to look into this, but apparently we're having an issue too. Anybody have some insight?

64493 YES this code is bundled.

64483 NO

the OP is asking about 64483 (TFESI) not facets

 

[specepic]

Lets say you do b/l L5 tfesi, are you guys doing a -50 ; or using 64483 and 64484?

Same work as a same sided L4 and L5 tfesi's (which actually would be less work given fluoro manip)

 

[mid|ine]

50 modifier.

Its bilateral and I believe this is the correct way to bill it.

I believe you can only bill for additional levels if they are different levels.

 

[Jcm800]

50 modifier.

Its bilateral and I believe this is the correct way to bill it.

I believe you can only bill for additional levels if they are different levels.

correct. if there is an "add on code" it implies a different level.
50 modifier for all bilateral procedures

 

[mdvol]

Looks like the 2011 code book does bundle fluoro ( and or CT ) with the transforaminal codes. There is a new code for US guidance though for a trans?

Discussion, thoughts?

 

[MedZeppelin]

Yes, I've read that TF ESI's will be automatically bundled with Flouro now, much like Facets were in the past....