tci Part B Insider - 2013 Issue 9

Add-on Codes: Know the 3 Types of Medicare Add-on Codes

CCI pays attention to the add-on tables. Shouldn’t you? CPT® doesn’t designate primary codes for every add-on code, but CMS offers a few clues about when you should report specific add-ons in Transmittal 2636, Change Request 7501, effective April 1, 2013. Background: An add-on code reports a service that is "always performed in conjunction with another primary service. An add-on code is eligible for payment only if it is reported with an appropriate primary procedure performed by the same practitioner. An add-on code is never eligible for payment if it is the only procedure reported by a...

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