by: Julia Kyles
Published Feb 1, 2012
You have new codes for facet destruction services (64633 – 64636) but that doesn’t necessarily mean you need to create a completely new template. Review the facet denervation template a practice used for 64622 – 64627 and see if you think it needs to be revised. The answer is below.
Answer: Provided the doctor properly completes this template, it should pass muster during an audit. Note that the template clearly spells out the procedure and twice states fluoroscopic guidance was used.
Warning: Some carriers’ guidelines may require a more detailed template that supports medical necessity, notes APCPS technical editor Debbie Farmer, CPC, ACS-AN, compliance auditor, Auditing for Compliance & Education, Leawood, Kan.
Example: According to WPS Medicare’s revised Local Coverage Determination for facet blocks and denervations: “The medically necessary reason for the use of CT guided imaging rather than fluoroscopy must be documented in the medical record.”
The template should either include the medical necessity information or refer to previous visit(s) for support, Farmer says.
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