27446, 27437 -51 or -59?

8907Chelsea

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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!
 
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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.
 
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