# 36224 and 36226 RE BUNDLING ISSUE



## margaret fahy (Sep 11, 2014)

Hi Guys,
Do you bill 36224 and 36226 together?
They do not come up as a CCI Edit, but a carrier is denying, stating that as the Cervicocerebral Arch is included in 36224, then we cannot bill 36226 with 36224.
I know this isn't so, as in description of 36226, it also says that the cervicocerebral arch is included.
Does anyone have documentation to support these codes not being bundled...
Thanks.
Margie


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## Jim Pawloski (Sep 11, 2014)

margaret fahy said:


> Hi Guys,
> Do you bill 36224 and 36226 together?
> They do not come up as a CCI Edit, but a carrier is denying, stating that as the Cervicocerebral Arch is included in 36224, then we cannot bill 36226 with 36224.
> I know this isn't so, as in description of 36226, it also says that the cervicocerebral arch is included.
> ...



A selective Internal Carotid and a selective Vertebral can be billed together.  Just make sure you have a anatomical modifier with it.  The arch is included with these codes.
Check in CPT, just after the A-V shunt descriptions.
Thanks,
Jim Pawloski, CIRCC


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## margaret fahy (Sep 12, 2014)

JIm,
Thanks...yes, we do bill these together all of the time...one of our A/R people came to me with some documentation from a carrier...with their reason for denial being that the vertebrals are included as the cervicocerebral arch was included in 36224...but the documentation said....cervicocerebral arteries rather than arch......i know there are no CCI edits....anatomical modifier....do you mean RT/LT?  I do append these mods...they do get denied by some carriers as they don't want RT/LT, so then i remove them and add a 59 mod to the second billing of 36224.
Thanks so much.
Margie


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