Coding strategy for an unlisted code | ENT reports | NS reports |
Comments |
---|---|---|---|
1. Both surgeons report the same unlisted code | 64999 | 64999 | Some payers will recognize this and reimburse accordingly while others will reject the claim as unprocessable. |
2. Both surgeons report the same unlisted code with modifier 62 | 64999–62 | 64999–62 | CPT guidelines state not to use a modifier on an unlisted code. However, some payers do recognize modifier 62 on an unlisted code. |
3. Both surgeons report their own unlisted code | 31299 | 64999 | More frequently recognized by payers and reimbursed. |