Mar 21st, 2018 - ChrisW 256 1
re: Genetic BRCA Counseling
The Genetic counseling codes all have a status indicator of "B".
Status indicators are assigned to procedures by CMS to indicate whether the code is covered or paid separately. Status indicator ‘B’ describes a “bundled code”, indicating reimbursement for this service is always included in the reimbursement for another service. While these are CMS' guidelines many other payers follow the same rules. In addition, it would be inappropriate to use Modifier -59 to over-ride code edits.
B = Payment for covered services are always bundled into payment for other services not specified. There will be no RVUs or payment amounts for these codes and no separate payment is ever made. When these services are covered, payment for them is subsumed by the payment for the services to which they are incident (an
example is a telephone call from a hospital nurse regarding care of a patient).