unbundling

  1. K

    Wiki Do you still see unbundling errors in practice?

    One would think insurance companies detect unbundling during claims processing but they still seem to be fairly common in practice. What is your experience?
  2. J

    Wiki Claim Denial: Mutually Exclusive Procedures

    Hello, everyone! I am not sure if this is posted yet. But I have a quick question regarding denials and appeals for California. Recently, we have had a denial for mutually exclusive procedures: unbundling for the codes as follows: 17000 - L57.0 AKs 17003 - L57.0 AKs 17110 - B07.00 Plantar...
  3. T

    Wiki Unbundling

    Can I get some insight on unbundling services? I have a couple of scenarios. 1. 64633-50, 99070, S0020, J3301 ( RF Ablation with use of lidocaine, Marcaine, and Kenalog. 99070 was billed for misc supplies) 2.99203-25 62321, 62323, 99070, J3301, Q9966 (New patient visit where a cervical ESI and a...
  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. baroquecoder

    Wiki Circumcision and Preventative visit

    Chief complaint: weight check & circumcision HPI formula feeding, gaining weight, appropriate responses.. Full ROS; negative as per HPI Exam; comprehensive Procedure note for the circumcision. Assessment plan; patient gaining weight appropriately continue vitamin d exposure with sunlight post...
    • baroquecoder
    • Thread
    • circumcision mod 25 pediatric preventative unbundling
    • Replies: 1
    • Forum: Pediatrics
  6. M

    Wiki Bundling procedures with catheter insertion/exchange

    Insurance companies bundle urinary catheter insertion/exchange with cystoscopy when performed on same date of service. Codes 52000 and 51702 or 52000 and 51701 for example. Does anyone have any advice/solution? Should HCPCS codes be billed to prevent bundling issues? Should/can the patient be...
  7. 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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