Wiki 29881 with 29884

[seslinger]

I have read alot of information on these 2 codes being bundled but can be unbundled with a -59 if in a separate compartment.

We were told there was an AMA article Aug 2001 that states that 29884 should not be reported with another major procedure. Would the AMA override the CCI edit of unbundling with a -59.

Any imput would be appreciated.

This is a private carrier.

Sheila, CPC

 

[nyyankees]

I have read alot of information on these 2 codes being bundled but can be unbundled with a -59 if in a separate compartment.

We were told there was an AMA article Aug 2001 that states that 29884 should not be reported with another major procedure. Would the AMA override the CCI edit of unbundling with a -59.

Any imput would be appreciated.

This is a private carrier.

Sheila, CPC

If it's in a separate compartment I would bill it as you are justifying the 59 modifier.

 

[nrichard]

If your billing to a federal payer, if both surgeries where done in the same knee, I would only bill the 29884.
If done in a separate compartment I would bill both, with -59 on the 29881, if the payer is commercial.
Research changes to bundling edits of arthroscopic knees, that went into effect 1/1/13.

Nichole, CPC, COSC

 

[OCD_coder]

Per Mary LeGrande of Zupko and Associates, the 29884 should not be reported with other arthroscopic procedures on the same knee. This regardless if the two procedures are in different compartments. The 29884 is designated by CPT as a "Separate Procedure" and like the mod-59 rules this code should only be reported when performed alone or on the contralateral knee; it is considered to be an integral component of the primary procedure in this case the 29881. The 29884 performed on the same knee at the same surgical session and same incision does not meet the requirements of "Separate Procedure" and to report with a mod-59.

http://www.karenzupko.com/resources/codingcoach/cc_orthoarchive_2013.html