• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Standards of medical/surgical practice question

RebeccaMoney

Guest
Messages
298
Location
Lees Summit, MO
Just to verify my understanding of the above in Encoder Pro. My understanding is that if I get this message and it still states that a modifier can be used, that modifier can only be used if the opposite side being operated on. Otherwise these codes are considered bundled. Am I correct? Thank you,
 
Key word your looking for is "Separation"

No matter the reason for the edit really the key to unbundling the procedures is "separation" which usually means a different incision, anatomy or the opposite arm/leg.

If there is no separation some how, they are bundled.

Keep in mind that Medicare does not allow -59 modifiers with shoulder surgery now.

But what you are thinking is correct in this case.
 
Yep, I use Encoder pro too..it means bundled and modifier 59 to be used only if it meets the requirements.
 
Top