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facility outpatient 23700/29826 billing

  1. Default facility outpatient 23700/29826 billing
    Medical Coding Books
    The professional side of the cci files states that 23700 has a subscript of "0" and cannot be billed with 29826.
    The facility side of cci files states that 23700 has a subscript of "1" and can be billed.
    I am confused. Should the billing on the UB for 23700 have no charges ($0.00) and I should bill it because it was done? Or should I bill the 23700 with charges? ($2,300.00) and hope it doesn't get denied?


  2. #2
    Columbia, MO
    Hospital CCI edits are different from physician, if it is modifieable and documentation supports then bill with charges on the hospital side. If it is not modifiable on the physician side then it cannot beilled on their claim.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    Thanks Debra. I didn't think I could bill for it because the surgeons claim was denied. I thought I would at least post the hcpc 23700 and put $0.00 in the charges to at least show it was done.

  4. #4
    Columbia, MO
    If documentation allows to unbundle it or if it is not bundled then by all means post with charges not $0. If you cannot unbundle it or if it is non modifiable then do not post it even with a $0. The payer can then pay you for the procedure that reimburses the least. If you are coding for the facility then it matters not what the physician side can or cannot bill. You follow facility guideliens and facility CCI edits.

    Debra A. Mitchell, MSPH, CPC-H

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