Question Unbundling of CPT 19370 with 11970

Kbrat29

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Hello there anyone....
I work in Plastic Surgery and have a Mastectomy Reconstruction Coding Question;
Anyone know how to unbundle CPT 19370 (Repair & Reconstruction on the Breast) with CPT 11970 ( Removal of TE).
CCI edits say it can be coded together and I used Modifier 59 but it's still denied by UHC.

Thank you so much for your reply!
 

thomas7331

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Does your documentation and do your diagnosis codes indicate that the two procedures were performed on different breasts? If not, then UHC may be recognizing that the modifier 59 is not supported, in which case the denial may be appropriate.
 
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