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sinus endoscopy with additional bil ear tubes

  1. #1
    Question sinus endoscopy with additional bil ear tubes
    Medical Coding Books
    I had a claim deny for Medicaid of Indiana for the billing of 31231 when billed with a 69436-RT-59 & 69436-LT-59. The 69436s pd but denial says 31231 is bundled. I cannot find anything on this. I could not find any NCCI edits either. If this is not billable please explain... Or should I fight this one with an appeal? This is for an ASC.
    Thank you! All comments are greatly appreciated!

    ~Melissa R, CPC

  2. #2
    I would appeal the claim. There are no CCI Edits bundling these codes. You might want to check your contract, our MCD program (in Missouri) requires us to bill bilaterals with a 50 modifier, and they do not recognize some of the modifiers.
    Last edited by bethh05; 01-26-2012 at 09:56 AM.

  3. #3
    Ok! Thanks for your help!
    ~Melissa, CPC

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