HOPD Billing

[gaspasser127]

My understanding is that in the HOPD setting we are only paid for the highest billing code if multiple codes are billed in the same procedure encounter.

My question is:

- is only the facility fee limited to the highest reimbursing code or is the physician fee as well?
- if you do a 2 level lumbar TFESI, do you only get paid for the first level?
- if you’re compensated for RVUs would you still be able to get RVU credit for both levels?

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[Ronin1]

I get paid for both
64483 1.9
64484 1.0

 

[Ducttape]

you will notice that 64484 is 1.0 instead of 1.9 and is essentially 1/2 of the first level.