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Wiki 96446-59 & 96365 being labeled as bundling

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leonefunk

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96446-59 & 96365 (labeled as bundling?)

I'm fighting with Medicaid trying to get them to understand these codes are distinct services. Somehow they think 96365 (IV infusion) is included w/in the 96446-59 (Peritoneal cavity PORT) procedure. :eek:

Does anybody have any ideas of how I should proceed with providing information needed to let them know these two codes are separately payable? (I've already sent them the CPT coding pages highlighting the distinctions within the first appeal).

Any help/ideas are appreciated. Thanks. :)
 
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According to the NCCI edits 96365 is a column 2 code to 96446 but a modifier is allowed to differentiate the procedures. The modifier would go on 96365.
 
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