Reader Questions ~ Don't Accept 51701-62270 Bundle
Published on Fri Oct 20, 2006
Question: A neonate came in with fever. We did a urine catheterization (CPT 51701 ) and a spinal tap (62270) in the office. May I report both 51701 and 62270?
Louisiana Subscriber
Answer: Yes. A urine catheterization (51701, Insertion of non-indwelling bladder catheter [e.g., straight catheterization for residual urine]) and lumbar puncture (62270, Spinal puncture, lumbar, diagnostic) are two separate procedures that you should separately report.
The National Correct Coding Initiative (NCCI) does not place an edit on the code pair, so a modifier should not be required.
However, you may need to indicate a multiple procedure by appending the lesser-valued procedure (51701) with modifier 51 (Multiple procedures). According to Medicare guidelines, this would reducepayment on the second procedure (51701) by 50 percent.
If the carrier does bundle the catheterization into the lumbar puncture, indicate that 51701 is a distinct procedural service from 62270 by using modifier 59 (Distinct procedural service) instead of modifier 51. If the insurer denies 51701-59, appeal the decision with documentation that shows two separate procedures.
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