ZHealth News

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.

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Posted in Free Newsletters By Sondra Dunn

2018 Change to Bone Marrow Biopsy Coding

Oct 31, 2017 12:05:48 AM

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. 

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - May 2017

May 28, 2017 2:22:00 AM

May 2017 Q & A

Question: 96374 with an Ablation

We had a case where Ibutilide was administered during an atrial flutter ablation procedure (93653). The Medicare claims processing manual, chapter 4, section 230.2 discusses this and says, "Hospitals should report all HCPCS codes that describe the drug administration services provided, regardless of whether or not those services are separately paid or their payment is packaged." 93653 had a "J1". 96374 has an SI of "S".

In your opinion, Ibutilide is inherent or not inherent to an ablation procedure, in which it's not always used as part of the procedure, to lets say contrast to an diagnostic angiography, is it then ok to bill 96374 for an IV push, and 96365 for an infusion, if they are given Ibutilide as part of an ablation for a flutter or A-Fib?

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Posted in Free Newsletters By Sondra Dunn

January 2016 Q & A

Question: 50435 and 50693

I have a doctor that did a left nephrostogram, ureteral stent insertion and a nephrostomy tube exchange at the same setting. With the new 2016 codes, there is no scenario with a pre existing nephrostomy tract tube exchange and a placement of ureteral stent. I am getting a CCI edit for 50435 saying it shouldn't be billed with 50693. Am I missing something, or misinterpreting something? Would you bill 50693, 50435-XU? Payer is Medicare.
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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - May 2015

May 15, 2015 7:58:00 AM

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.

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Posted in Free Newsletters By Sondra Dunn

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