Wiki Hand/wrist bundling

sienamt

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One of my ortho docs wants to perform a thumb CMC arthroplasty (25447) and a proximal row carpectomy of scaphoid, lunate. triquetrum, pisiform (25215) on the same hand and in the same surgical session.
25447 and 25215 are bundled but I think I can use -59 to unbundle since they are separate procedures and separate incisions? Thoughts?
 
Can be unbundled

For the CMC arthroplasty the removal of the trapezium is included since that is part of the procedure. If a different carpal bone is removed, and has separate pathology, then that can be billed with a modifier. Removal of the other carpal bone must have separate and unrelated pathology in order for it to qualify to be billed separately.
 
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