• 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..

Unbundled relationship

M

MHSULLIVAN

Guest
Messages
13
Location
LAS VEGAS, NV
I know this is a thread of great experience and I am only just getting into coding, so I would be so grateful for some expertise. I am dealing with a Medicare rejection, saying 93458 and 75756 have an unbundled relationship. Any wisdom?
 
Do you have knowledge or understanding of NCCI edits and bundling at all yet? Have you learned this information in your experience up to now? What is your understanding of bundling?
You can look up edits on tools like this one: https://www.cgsmedicare.com/medicare_dynamic/j15/ptpb/ptp/ptp.aspx
Encoder programs also have edit checkers.
If you are unfamiliar you may want to start reading about NCCI edits here: https://www.cms.gov/medicare-medica...-correct-coding-initiative-ncci/ncci-medicare

You would want to check the relationship between these two codes when reported at the same encounter.
 
I agree with @amyjph

It is important for you to familiarize yourself with NCCI edits and learn how to check them. Amy gave you some great links to start with your research.

I will add that 93458 and 75756 cannot be billed together. There is an NCCI edit and a modifier is not allowed to override the relationship. 93458 is the primary code in that relationship.
 
You must log in or register to reply here.
Top