Ask Dr. Z

Our organization allows departments to report G0269 closure device; HOWEVER, our coders do NOT append a modifier to bypass the edit for additional reimbursement, as we understand this is a packaged service. We report all procedures performed under the OPPS, as long as coding guidelines permit. To our understanding, reporting all procedures performed within guidelines support CMS with future decision making regarding MUEs and packaging status for example. Regarding 76937 ultrasound guidance, currently, you do not receive an edit with 93458 and 76937 for HOPD billing. The current 2019 NCCI Policy is only addressing physician billing. Should the facility continue to report ultrasound guidance when performed with cardiac, coronary, EP, PPM/ICD procedures? Please advise on facility reporting to ensure our healthcare organization is reporting services appropriately.