Coding 52000 with 51701.
CCI edit bundles these two codes and no modifier is allowed to override the relationship. Per CCI, 52000 is primary and 51701 is secondary.
Can anyone provide feedback as to which code to remove? I have received 2 different responses.
Response #1: Remove 51701. The provider performs 52000, the procedure is primary over the other 517 codes, and the work involved, fee and RVU are higher.
Response #2: Remove 52000. This has a separate procedure designation, by definition is usually a component of a more complex service and is not identified separately. When performed alone or with other unrelated procedures/services it may be reported. If performed alone, list the code; if performed with other procedures/services, list the code and append modifier 59.
*Side note: this was done in conjunction with 51701 which is a less extensive code. Does the "separate procedure" rule apply in this case?*
Any feedback is appreciated.
Thank you,
C.Mam
CCI edit bundles these two codes and no modifier is allowed to override the relationship. Per CCI, 52000 is primary and 51701 is secondary.
Can anyone provide feedback as to which code to remove? I have received 2 different responses.
Response #1: Remove 51701. The provider performs 52000, the procedure is primary over the other 517 codes, and the work involved, fee and RVU are higher.
Response #2: Remove 52000. This has a separate procedure designation, by definition is usually a component of a more complex service and is not identified separately. When performed alone or with other unrelated procedures/services it may be reported. If performed alone, list the code; if performed with other procedures/services, list the code and append modifier 59.
*Side note: this was done in conjunction with 51701 which is a less extensive code. Does the "separate procedure" rule apply in this case?*
Any feedback is appreciated.
Thank you,
C.Mam