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58120 denied

  1. Question 58120 denied
    Medical Coding Books
    does anyone know if 58120 can bill with 58145?

    Thank you!

  2. #2
    Location
    Indianapolis
    Posts
    187
    Default
    According to the NCCI edits, 58120 is bundled into 58145 with 58145 being a more extensive procedure. However, the pair has a modifier indicator of 1 which means "modifier allowed; billed services may be justifiable for the code combination (For comprehensive/component pair, use modifier on column 2 code; for mutually exclusive pair, use modifier as appropriate)."

    Hope this helps!
    Chandra L. Stephenson, CPC, CIC, COC, CPB, CPCO, CPMA, CPPM, CRC, CCS, CPC-I, CANPC, CCC, CEMC, CGSC, CFPC, CIMC, COSC
    2012-2013, 2016 President, AAPC Indianapolis Indiana Chapter
    2013-2015 AAPC National Advisory Board Member
    chandra.stephenson@gmail.com

  3. Default
    I agree with NCCI totally bundling 58120 on to 58145 which is a major procedure with the same approach and as an open procedure. No other option.
    But if D&C performed by hysteroscopy and the 58145 also done , then that d& c of hysteroscopy 58558 should be reported separately.

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