09/28/21 | CMS gives more insight into appropriate DOS for imaging

The Center for Medicare and Medicaid Services (CMS) has guidance for reporting the date of service (DOS) for various services. Information provided for global reporting, technical reporting and professional reporting


CMS gives more insight into appropriate DOS for imaging
07/01/21 | New CPT code for Subchondroplasty

Effective July 1st 2021 - the AMA released a new code for Subchondroplasties - are you ready for it

New CPT code for Subchondroplasty
03/17/20 | Telehealth regulations loosened

With the Coronavirus issues CMS has loosened the regulations and HIPAA issues that have caused concerns about when telehealth can be used. Check out the new release

Telehealth regulations loosened
01/29/20 | New Drug Delivery Codes 20700-20705

Stop using 11981-11983 as of Jan 1st 2020- Use the new drug delivery codes 20700-20705 --

New Drug Delivery Codes 20700-20705
04/04/19 | Watch your "stem cell" wording - On going FBI investigations

For those offices that are using the wording 'stem cells' or charging patients for these services you need to be aware of the FBI ongoing investigations.

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02/28/19 | Great article on the issues with 63047 and 22633 and 22630

Find out about the issues between 22633/22630 and 63047 and get the history of these codes.  Great information you can use for your private payer appeals.

Great article on the issues with 63047 and 22633 and 22630
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CPT updates their policy regarding nerve root decompressions and interbody fusions

AANS, NASS and AAOS have been working hard on getting CPT to change their previous October 2016 CPT Assistant regarding nerve root decompression 63047 and interbody fusion 22633 being inclusive.  As of the May 2018 it appears that those specialty societies have accomplished CPT/AMA to change that policy.  In the May 2018 issue they reversed their previous October 2016 Assistant stating:

On further analysis of this issue, it was demonstrated that this recommendation was inconsistent with previously published CPT® Assistant advice, which is that codes 22633 and 63047 may be reported for the same interspace when additional work is required to complete a decompression at a single spinal level. It is also appropriate to report codes 22633 and 63047, if the two procedures are performed at different interspaces. Modifier 59, Distinct Procedural Service, should then be appended to indicate that these are two distinct procedures.

This correction aligns the coding advice with historical precedent published prior to the incorrect revisions in advice given in the October 2016 FAQ.”

However, this change does not appear to have affected Medicare’s opinion via the NCCI guidelines Chapter Four which states that they continue to feel that 63047/63042 are inclusive in 22630/22633 unless performed at a different interspace.  Meaning that if they did nerve root decompressions of L2, L3, L4 and L5 and also did a PLIF (22630) or double fusion (22633) and L4/5 – you will only be able to report 63047-59 (L2 nerve root); 63048-59 (L3 nerve root) as the nerve root decompressions of L4 and L5 will continue to be bundled into the 22630/22633.

What this change does to is allow you to use it in an appeal with your private payers if they deny your reporting of 63047 and 63048s with 22633 when performed at the same levels. But keep in mind, if your contracted payers state that they follow NCCI guidelines and edits, they may still be able to deny reimbursement.

NASS and the other societies are still trying to work with Medicare/NCCI to over-turn this bundling but as of the updated 2nd quarter edits it is still there.