Wiki Billing 64425 with 11900

[evillan2015]

64425-59 was denied with other procedures billed 20553-59, 11900-59 - denied as service incidental or mutally exclusive to the primary procedure. Inconsistent with current NCCI coding protocol. Should I have not placed 59 on main procedure 64425? please advise. how I should have billed.. thank you

 

[CodingKing]

Per NCCI Edit 64425 is a Column 2 code to 11900 with no modifiers are accepted listed as Standards of medical / surgical practice. If its truly unrelated to the other 2 codes you would have to appeal. This edit affects thousands of codes since local and regional blocks are bundled into the other procedure

 

[mitchellde]

Was each procedure independent of the others? What were the diagnoses used?

 

[evillan2015]

reimbursement for 11900 & 64425

Per NCCI Edit 64425 is a Column 2 code to 11900 with no modifiers are accepted listed as Standards of medical / surgical practice. If its truly unrelated to the other 2 codes you would have to appeal. This edit affects thousands of codes since local and regional blocks are bundled into the other procedure

so I should have billed 11900-59 but without the modifier and if it is unrelated?

Please advise,

Elizabeth