Medical Billing Forum
Payments => Insurance Payments => : sharonb364 August 21, 2015, 05:07:49 PM
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We're taking on a new project and have been asked if we can help with sample codes and fee schedule information for the following:
Sample hospital and physician payments for procedures like:
- A tumor biopsy during CT
- A tumor ablation during CT :
o Radiofrequency with Boston Scientifc, Olympus, Covidien… needles
o Cryogeny with Galil or Angiodynamics needles
o Microwaves with Covidien needles
- Cement injection in the spine of femoral neck
- Infiltrations in spine for pain management
- etc.
Any help with this would be greatly appreciated!
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As you know, fee schedules are Carrier-Specific. There is not one answer to your question about fee-schedule information.
Google on the phrases you included as bullet points in your post. For example:
googling on ct-guided biopsy brings up a list of related links, among which you will find this:
http://radiology.mckessonrevenews.com/index.php/archives/10-documentation-and-coding-image-guided-percutaneous-needle-biopsy-and-fine-needle-aspiration
or the pdf version
http://radiology.mckessonrevenews.com/pdf/McKesson_Radiology_Newsletter_Ask_The_Coder.pdf
Which tells you that CT guidance for needle placement = 77012 -
And then you can scroll down to a large selection of codes that specifiy whether you performed a tissue biopsy versus a cellular or fluid sample (different codes for each) and which site you biopsied (again, different codes for each).
Repeat this process for each of your bullet points. This should get you started. Good luck.
(The document I linked to is actually quite good. I recommend reading it carefully for its recommendations about careful documentation to support the CPT codes selected.)
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Thank you! we are exploring this for a client that's new to the US healthcare arena.
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You're welcome. If you find any useful links in your search, you might come back and post them here. For the sake of others who come by later looking for information like this.
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Thanks for sharing this useful piece of information.!!