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Author Topic: 58563 billed with 58120  (Read 16164 times)

jwangelin

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58563 billed with 58120
« on: November 16, 2010, 10:39:35 AM »
I work for an Ob-Gyn physician.  She performs ablations and at the same time does a D&C.  Can I bill 58563 along with 58120 and mod 51, or is 58120 considered part of 58563?
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oneround

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Re: 58563 billed with 58120
« Reply #1 on: November 16, 2010, 01:40:08 PM »
How are they doing the ablation are they using Novasure?
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Michael A. Reynolds, CPC, CCP-P, CPMB, OS
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Corporate Compliance
Sharp HealthCare

jwangelin

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Re: 58563 billed with 58120
« Reply #2 on: November 16, 2010, 05:46:51 PM »
Yes
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oneround

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Re: 58563 billed with 58120
« Reply #3 on: November 16, 2010, 07:33:59 PM »
CPT/HCPCS to CCI Code Check


NOTE: Effective 1/1/09, the facility version of NCCI edits will include edits for the following categories of service: Anesthesia (00100-01999), E&M (92002-92014, 99201-99499), and MH (90804-90911). Prior to 2009, these code pairs were excluded from the facility edits.

Code / Description 
58563  HYSTEROSCOPY, ABLATION M  Rel Wt: 37.22   
 
 
No bundling issues exist 
58120  DILATION AND CURETTAGE M  Rel Wt: 20.05   
 
 
Code 58120 is a component of Column 1 code 58563 but a modifier is allowed in order to differentiate between the services provided.
 
 



 
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Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

jwangelin

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Re: 58563 billed with 58120
« Reply #4 on: November 17, 2010, 03:40:15 PM »
So is 51 the appropriate mod, or is 59.
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Medical Billing Forum

Re: 58563 billed with 58120
« Reply #4 on: November 17, 2010, 03:40:15 PM »

oneround

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Re: 58563 billed with 58120
« Reply #5 on: November 17, 2010, 08:02:46 PM »
 Had the D&C been performed for diagnostic purposes for a clearly separate indication, you could report 58120 separately with modifier 59 (distinct procedural services) appended to override the CCI edit otherwise the 58563 would cover it all
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Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

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Re: 58563 billed with 58120
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