Wiki Arthroscopy of elbow

[LIVE2CODE]

I've received bundling edit for Loose Body removal and synovectomy of the Elbow. should I use modifier 59

 

[sequester25@gmail.com]

I'm not showing any NCCI edits for bundling with just those two CPT's (29834 & 29835) and modifier -59 is not needed. Is this a denial from one of your payers? If so, are you contracted with this payer? Might need to get there policy regarding billing these two codes together.

 

[Orthocoderpgu]

AAOS allows both codes as well

Since these codes don't hit an NCCI edit and AAOS allows both, your probably looking at a contract issue with the insurance which the previous coder mentioned.

 

[LIVE2CODE]

Since these codes don't hit an NCCI edit and AAOS allows both, your probably looking at a contract issue with the insurance which the previous coder mentioned.

I did not show any NCCI Edits as well, that's why I billed the codes, but the claim is hitting a scrub edit. Code billed are 24359 29835, 29834. I am thinking that CPT 29835 will deny and maybe included in 24359. Any other suggestions??

 

[MI_CODER]

I use a coding software (3M) and this is the information that it gives me:

Procedures INCLUDED in the global service package for CPT code '29834 - Arthroscopy, elbow, surgical; with removal of loose/foreign body' are:
-Articular shaving/debridement/limited synovectomy incidental to procedure
-Small skin incision to assist removal
-Diagnostic elbow arthroscopy

Procedures EXCLUDED from the global service package are:
-Complicated wound closure
-Supplies and medication

References: Complete Global Service Data

Procedures INCLUDED in the global service package for CPT code '29835 - Arthroscopy, elbow, surgical; synovectomy, partial' are:
-Articular shaving/debridement/limited synovectomy incidental to procedure
-Synovectomy of one compartment
-Diagnostic elbow arthroscopy

Procedures EXCLUDED from the global service package are:
-Complicated wound closure
-Removal of loose/foreign body through a separate incision
-Supplies and medication

Reference: Complete Global Service Data for Orthopaedic Surgery, American Academy of Orthopaedic Surgeons

Would it be possible for you to post the op note just so we can see exactly what was done?

 

[sequester25@gmail.com]

This seems strange that you would get a scrub edit for bundling. Have you re-checked all your diagnosis codes? Modifiers are correct? It's usually something small, but maybe re-entering the codes will help.