Question Please Help 29877/29873

savitag67

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Is there anything recent out there that substantiates to procedure code 29877 being reimbursed as primary to 29873. Every document that I can find including the NCCI edit states that procedure code 29877 is inclusive to 29873 when performed on the same knee. My manager wants me to appeal this stating that because 29877 has a higher RVU it is the primary procedure and therefore should be reimbursed. Please help, I'm going crazy. Thank you
 

Orthocoderpgu

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Between those two codes 29877 does have the higher RVU value but since it's bundled with 29873 that code becomes primary. It's the same with 29877 and 29881. I don't agree, but that's the way it is. You have no grounds for appealing since 29877 gets bundled into 29873.
 
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savitag67

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Thank you, I tried explaining that but because she doesn’t agree with me I have to appeal the denial, to me it’s a waste of time and makes me look idiotic, thanks again for your input
 
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