Wiki 27446, 27437 -51 or -59?


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We have a new physician at our orthopedic practice. With his unicompartmental knee replacements (27446) he also does a patelloplasty (27437). Per CCI edits I add a 51 modifier, however we have been getting A TON of denials back on these; almost all of them. I've tried switching the 51 to a 59 and rebilling, and some are getting paid. Does anyone have any suggestions or explanations that would help me to better understand this code combo and modifiers?

Thanks for the help!
27437 bundles with 27446, a modifier is allowed but you'd have to have the documentation to show the procedures were distinctly separate from one another. Modifier 51 won't break a bundling edit.