Advanced Search

Orthopedic Coding Alert

Reader Questions:

Appeal This BCBS Misconception

Published on Sat Apr 25, 2009

Question: I am having trouble with Blue Cross Blue Shield (BCBS) with my medial meniscectomy (29881) and lateral meniscal repair (29882) claims. Representatives tell me I can't use modifier 59 to charge both codes. Is their advice correct? South Dakota Subscriber Answer: Provided both procedures are distinct services, meaning your physician worked on separate compartments, you can report 29881 (Arthroscopy, knee, surgical; with meniscectomy [medial OR lateral, including any meniscal shaving]) with 29882 (- with meniscus repair [medial OR lateral]).  The Correct Coding Initiative (CCI) bundles 29881 and 29882. When your documentation supports a separate compartment, then you should append modifier 59 (Distinct procedural service).  Because CCI makes 29882 mutually exclusive to 29881, append modifier 59 to 29882 -- even though this is the higher valued code. Not all commercial payers follow this CMS guideline. If you receive a denial, be sure to appeal.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Orthopedic Coding Alert

View All