Retroactive Billing Medicare for Drug Coated Angioplasty Balloon Code C2623 with AV Dialysis Intervention Codes

Medicare is allowing pass-through payment for code C2623 with AV dialysis interventions for claims filed retroactively for dates of service from August 25, 2017, through December 31, 2017. Pass-through payment wasn’t made with this combination in 2017 due to Medicare not changing its limited coverage for the catheter’s use only in the femoral popliteal arteries. Effective January 1, 2018, pass-through payment for code C2623 ended.

On January 1, 2018, long-utilized HCPCS code G0364, Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date aof service, will be retired. 

May 2017 Q & A

Question: 96374 with an Ablation

January 2016 Q & A

Question: 50435 and 50693

May 2015 Q & A

Question: Coding Both Bone Marrow Aspiration and Bone Marrow Core Biopsy

According to the AMA’s CPT Assistant March 2015, when both bone marrow aspiration and bone marrow biopsy of the same site are performed, we can code both 38221 and 38220. Since there is a NCCI edit between the two codes, can we use modifier -59 to override this edit? Please clarify. Thanks.