Author Topic: billing 76000 and 75989  (Read 2199 times)

MBP

  • Jr. Member
  • **
  • Posts: 85
billing 76000 and 75989
« on: April 19, 2010, 12:36:41 PM »
does anyone bill placing a port under fluoro? i am having the worst time with these claims, the radio guidance keeps getting denied. the codes i get from my doctor are: 36571, 75989/26 and 76000. i checked ncci and figured 76000 is bundled with 36571 and 75989 is bundled with 76000. i told this to my dr and she wanted me to apply mod 59.. i did, but still rejected.. does anyone know how to bill these together? i have tried to search online, but couldnt find anything even about billing 76000 and 75989 together..  ???

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4762
    • Solutions Medical Billing
Re: billing 76000 and 75989
« Reply #1 on: April 20, 2010, 07:48:46 AM »
Which code did you apply the 59 modifier to?

Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

MBP

  • Jr. Member
  • **
  • Posts: 85
Re: billing 76000 and 75989
« Reply #2 on: April 20, 2010, 08:04:44 AM »
i applied it to 76000 b/c it is bundled with 36571. it got rejected, i submitted again with 59 with both, 76000 and 75989, rejected, so i submitted with 59 on 76000 and 51 and 59 with 75989, b/c 75989 is bundled with 76000.. all rejected. running out of options, i thought i would ask for an advice here before sitting on hold for 45 mins when i call medicare..

blhoffman

  • Full Member
  • ***
  • Posts: 112
Re: billing 76000 and 75989
« Reply #3 on: April 20, 2010, 09:03:31 AM »
http://sz0013.wc.mail.comcast.net/service/home/~/CHAP9-CPTcodes70000-79999_final083109.pdf?auth=co&loc=en_US&id=43661&part=2

This is from CMS Claims Processing Manual. It has really good information in it. The manual is updated for 2010 - page IX-11. I found the whole thing interesting, but then again - I'm a dork  ;D

I hope it is helpful to you. I'm not sure if the link will work. I hope so.


Brenda

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4762
    • Solutions Medical Billing
Re: billing 76000 and 75989
« Reply #4 on: April 20, 2010, 07:56:01 PM »
Dorks are what keep the world moving forward!   ;D
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

MBP

  • Jr. Member
  • **
  • Posts: 85
Re: billing 76000 and 75989
« Reply #5 on: April 21, 2010, 10:37:18 AM »
thank you both. it still doesnt help me find the answer. but it sure confirmed that you are a research guru Brenda! :)

oneround

  • Full Member
  • ***
  • Posts: 227
Re: billing 76000 and 75989
« Reply #6 on: April 21, 2010, 10:48:59 AM »
Here's what I get, is your documentation supporting the -59?

Code / Description 
36571  INSERT PICVAD CATH M  Rel Wt: 25.33   
 
 
No bundling issues exist 
76000  FLUOROSCOPE EXAMINATION M  Rel Wt: 1.27   
 
 
Code 76000 is a component of Column 1 code 36571 but a modifier is allowed in order to differentiate between the services provided.
Code 76000 is a component of Column 1 code 75989 but a modifier is allowed in order to differentiate between the services provided.
 
75989  ABSCESS DRAINAGE UNDER X-RAY M  Rel Wt: 0.00   
 
 
No bundling issues exist 
 
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

MBP

  • Jr. Member
  • **
  • Posts: 85
Re: billing 76000 and 75989
« Reply #7 on: April 21, 2010, 10:54:33 AM »
I have not seen the op report, I have got those codes from the MD, notified her of the rejections and she told me to bill it with -59. I explained how -59 works and she told me her report supports the use of it. so i billed it, but can't get the 3 of those paid together. from your info, -59 with 76000 and -59 with 75989 correct? that didnt work..

oneround

  • Full Member
  • ***
  • Posts: 227
Re: billing 76000 and 75989
« Reply #8 on: April 21, 2010, 01:11:57 PM »
-59 on the 76000 s/b enough.  And  they still denying the 76000-59 as still inclusive?  Who is the carrier?
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare