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Wiki Bundled Services

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heatherwinters

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If you are billing two insurances for a patient, the first insurance bundles two codes together the second insurance doesn't, how do you code the visit? Do you follow the primary insurance's rules and bundle the two codes together for both insurances even though the second would have paid for both?
 
Why is the first insurance bundling the codes, are they part of CCI edits? (I know CCI is Medicare, but many insurance companies follow their guidelines). If the first insurance company is following medicare guidelines and this is part of a CCI edit, I'd code itthe way they want. Otherwise, if they are the only ones bundling these codes, I'd try to find out their rationale for the policy.

Doreen, CPC
 
Unfortunately you are stuck following the primary insurance carrier guidelines. Occasionally, a 2ndary carrier will pay regardless of how the primary carrier processed, but I wouldnt hold my breath.

Mary, CPC, COSC
 
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