Author Topic: Intraoperative Spinal Monitoring  (Read 1244 times)

nholden

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Intraoperative Spinal Monitoring
« on: March 20, 2013, 04:53:29 PM »
Please help.  The woman who was doing this quit...I currently only do the DME billing and have been asked to step up.  In going through previously submitted claims she was using 95920, 95925, 95926, 95861.  Which are being denied due to the 95920 being an obsolete code, I dont even know where to begin.  Can anyone help me with what I should be replacing that code with? Thanks!

Billergirlnyc

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Re: Intraoperative Spinal Monitoring
« Reply #1 on: March 27, 2013, 02:17:26 PM »
To the codes:

This is correct 95920 is a deleted code. The news codes are 95940 and 95941, which are add-on codes, which means they can't be reported alone, you'll need the primary code to bill either. Medicare doesn't accept the 95941 code, so you'll need to use their G code, which is G0453.

I'm confused was she billing 95925 and 95926 together? If she was that may be a reason for denial as well. My info, from coding expert, specifically says these 2 codes shouldn't be billed together --- 95925 - isn't billed w/95926 and if 95926 is unilateral modifier 52 needs to be used to report that. There is no modifier listed for 95925.

95861 - Needle electromyography; 2 extremities with or without related paraspinal areas -  is still an active CPT code.

I'm thinking 2 issues is the use of the deleted code and possibly billing 95925 and 95926 together.

I also found a link to the AA0-HNSF, which goes into more detail about the 2 new codes and Medicare's determination, etc. http://www.entnet.org/Practice/Coding-for-Intraoperative-Neurophysiology-Testing.cfm
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