Wiki Help. Billing issue with CPT 23700 with 29826

[daedolos]

Are CPT 23700 and 29826 mutually exclusive? I'm having issue with a claim being paid because the insurer says they contradict one another.

Peace
?_?
Any help appreciated. Thank you in advance.

 

[CodingKing]

What is the primary code being reported?

29826 is an add on code and needs a primary code (29806-29825, 29827, 29828)

23700 is a column 2 code to 29826

Per NCCI Manual on 23700

When it is necessary to perform skeletal/joint manipulation under anesthesia to assess range of motion, reduce a fracture or for any other purpose during another procedure in an anatomically related area, the corresponding manipulation code (e.g., CPT codes 22505, 23700, 27275, 27570, 27860) is not separately reportable.

 

[daedolos]

It was originally intended for a 29827 but when the doctor had visual confirmation that the rotator cuff wasn't as bad as was originally thought, he performed 29826 instead and did a manipulation afterwards to assist with external rotation issues. In the past 29826 was a stand alone code. I was asked if it was possible to add 29827-52 or 29822.

Peace
@_*
Thank you for your feedback.