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[sgochoco]

When coding 37785 and 37700, the 37785 is a component of the 37700, but can be billed with a modifier. I would interpret this to mean that if the Physician performed each of these procedures through seperate incisions I could bill both, even if performed on a different area of the same leg. However, I am getting rejections for our local carriers telling me these codes are bundled and cannot be paid seperately. Does anyone else have an opinion on this particular scenario ?

Thanks,
SLG

 

[thompsonsyl]

Hi,

I'm showing on CCI Edits that 37700 is a component of 37785 and that it is modifiable to unbundle, as in the scenario you describe (different incisions). I believe that the modifier should therefore go on the 37700. Is that how you've been billing it?

 

[sgochoco]

slg

Yes, that is how I've been billing it. I have a rejection from a local carrier that says it is bundled, but Charge Entry did not append the 59 modifier to the 37700, so I will rebill this.

Thanks for your input.

SLG.