29827 and 29822

irvinme

Contributor
Messages
13
Location
Grand Rapids, MI
Best answers
0
provider did 29827 and 29822 to the shoulder. CCI shows this edit can be bypassed (29822-59). BCBS clear claim connection shows that these 2 codes are allowed with modifier 59 added to 29822. However Blue Care Network is denying 29822 inclusive to 29827. Can anyone help with this??
Thank you! Mary
 

karinquiterio

Networker
Messages
31
Best answers
0
I have the same scenario. My doctor did a RCR and labrum debridement. the 29822-59 is being denied as inclusive
 

OCD_coder

True Blue
Messages
938
Location
Nashville AAPC Chapter
Best answers
0
If the 29827 and 29822 are performed on the same shoulder joint, the NCCI edit means that the two procedures cannot occur on ipsilateral (same) shoulder joints in order to correctly apply modifier 59.

An NCCI edit is created with code combinations when at least 75% of all surgeons perform this code set together at the same surgical session, then they bundle them together and are not billable with a modifier 59.

This forum string all ready answers your identical question and has resources identified for you.
https://www.aapc.com/memberarea/forums/showthread.php?t=86164
 
Top