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Denials for bundled codes 23412 and 29826

  1. #11
    Default What if we look at it from this perspective rather than just the codes and laterality
    Clearnace Sale
    Prior to 2012, CPT code 29826 was a standalone code and according to NCCI, was clearly bundled w/23412 unless it was a separate encounter or opposite shoulder. In 2012, CPT code 29826 changed from a standalone code to an add-on code. You can now report this only when your surgeon does another scope procedure. (Supercoder) (Note: if the parent scope procedure code does not have a CCI edit with 29826, and the 29826 is clearly documented as being related to that parent scope procedure [and not the OPEN Rotator Cuff Repair- 23412], then the CCI Edit does not apply to the 29826 because it is an add-on.)

    So, from that I gathered that 29826 is an add-on to codes 29823/24 (arthroscopic synovectomy, debridement of biceps tendon, sub acromial decompression & clavicular resection). If 23412 does not appear to be a procedure that was converted from an arthroscopic procedure to an open procedure, and since there is no CCI edit to the parent codes of 29826; the add-on code would be payable too, since itís stemming from the parent and not the rotator cuff repair.

    Thoughts?

  2. #12
    Default
    Did Supercoder allow you to use this methodology? I recall a trial pass where I had access for a day to use their services and it would let you know in an instant whether or not bundling was an issue as well as accepted diagnoses.

    Peace
    ?_?

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