bundling

  1. G

    Wiki Medicare is not paying 76937-26 for 93503

    I work with Palmetto and Noridian. I cannot find any literature for why Medicare is stating that 93503 is not a valid primary procedure code for 76937-26. They pay when we also bill 36620 or 36625, so does anyone have any insight for how we can get the ultrasound guidance paid for just the 93503...
    • Gordon2020
    • Thread
    • anesthesia coding bundling medicare billing swan ganz ultrasound guidance
    • Replies: 1
    • Forum: Anesthesia
  2. W

    Wiki 28003/28005 with 28120, 28122, 28222, etc

    I am new to podiatry coding. There is a physician billing 28003 and 28005 (which are NCCI bundled with the following)... 28122, 28062, 28222, 28120.... Mostly diabetic foot infection procedures for debridement/incision and drainage. Is it appropriate to bill the incision portion of the...
    • wkb4173
    • Thread
    • bundling debridement diabetic foot podiatry wound care
    • Replies: 3
    • Forum: Podiatry
  3. L

    Wiki Multiple Claims in 1 Day

    I'm taking over the Compliance portion for a small Dermatology Office. Right now the provider will submit MOHs on one claim, but then submit the biopsy on a different claim that gets signed off a week or more later. And another provider will chart and bill for the closures. This is causing...
  4. C

    Wiki NCCI Edit help requested

    Greetings! Looking for everyone's best advice on NCCI edits! I have been certified a couple years now and have basic understanding of NCCI edits - but would like to do a deeper dive and wonder if anyone has great advice, best resource(s), etc. to recommend. How did you get to the best...
  5. C

    Wiki New bundling denials for 17000/17262

    We've recently been receiving denials for bundling when we bill the codes 17000, 17003 with destruction codes 17262 etc. We have always billed these with the 59 modifier on the 17000/17003 and when I check the CCI edits it's still saying that is correct. But now we are receiving these new...
  6. A

    Wiki Billing 99213, 11721 & 11055 Humana

    I am having a hard time getting the any office visit code (99212, 99213, 99214) 11721 & 11055 all paid by Humana. I have always had trouble with this insurance bundling these services and only paying for the lower dollar amount item (this example 11055 was the only one paid). This is how I...
  7. C

    Wiki 51/59 Nerve Block Modifiers - bundling issue

    Hello- I work for a neurology office - having some difficulty with a bundling issue. On an extreme case I could bill for one patient: 64450 64405 20553 64615 96372 How i was trained - typically I would use: 64450 - 50, 59 64405 - 59 20553 64615 96372 - 59 BCBS - pays for all minus 20553 -...
    • certick
    • Thread
    • bundling modifier 51 modifier 59 nerve block trigger point
    • Replies: 1
    • Forum: Modifiers
  8. D

    Wiki 29824 denied for bundling with 29827

    I'm at my wits end. A Blue Cross Medicare Advantage plan is denying CPT 29824 as being bundled with 29827. Both procedures were most definitely done. I tried billing with a modifier 51 and it's still denied as bundled. Chart notes have been submitted. They insist that this code is bundled...
  9. E

    Reverse shoulder arthroscopy and bundling

    Help please please please! Our coding service said one of our docs is reporting a bunch of coding for a reverse shoulder arthroscopy that they say are bundled. I am not finding any NCCI edits, and I don't know if that means that it is such a "duh" bundle that they don't have an edit for it, or...
  10. E

    Wiki Entire spine x-rays vs individual codes for c spine, t spine and l spine

    I was wondering if anyone had information regarding billing the entire spine X-ray codes vs billing the individual codes for C-spine, T-spine and L-spine X-rays? Our radiology practice normally codes each body part separate, unless they are performing the scoliosis study. Is there any specified...
  11. V

    Wiki Breast Reconstruction - reviewed Medicare

    Hello everyone, I work for a Plastic and Reconstructive Surgeon in Birmingham, MI. We just reviewed Medicare CCI edits and it is including 14301 (adjacent tissue transfers) in the breast reconstruction codes along with 15734. Our practice is primarily breast cancer patients, so these bundled...
  12. S

    Wiki Can CPT 49446 be billed separately from 43830?

    CPT 49446 states that for converstion to gastro-jejunostomy tube at the time of initial gastrostomy tube placement we are to use 49446 in conjuction with 49440. CPt 49440 is for a percutaneous approach. Our doctor performed an open approach which was coded as 43830. I have received a bundling...
  13. A

    Wiki Cci edit question

    :confused:THE DECRIPTION OF THE CPT CODES 74400, 74415 AND 74420 STATES IT IS WITH OR WITHOUT KUB. PER CCI EDITS THESE CODES AND THE KUB (74000) ARE NOT MUTUALLY EXCLUSIVE AND CAN BE BILLED W/ 59 MOD. WHICH TRUMPS THE OTHER, CCI OR CPT? ALSO, FOR 74400 IT STATES WITH OR WITHOUT TOMOGRAPHY BUT...
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