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Wiki 31237 vs 30430

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jocoffey

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Hello,

We received a denial on cpt code 31237 being inclusive to cpt code 30430. Our code correct system does not show these 2 codes are bundled. Does anyone know why they would deny?

Thanks in Advance
 
They are probably applying separate procedure logic (31237 has the "separate procedure" in code desc) though there is no NCCI edit between these 2 codes. Probably payer custom edit.
 
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