Wiki Bundled Injections

[vmidla]

Is anyone having problems getting 27096 & 62311 paid on the same claim? Pain doctors are doing both injections for different diagnosis. Been billing as follows -
62311
27096-59
Insurance is paying 27096-59 and then stating the modifier is missing from 62311 - any thoughts?

 

[jdrueppel]

Check the NCCI edits. Effective 4/1/09 62311 is inclusive of 27096 with a qualifier of "0" which means cannot over-ride with a modifier. There are lots and lots of block bundling CCI changes that went into effect 4/1/09.

NCCI weblink:
http://www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp#TopOfPage

Julie, CPC