# Unbundled charges



## mowalker (Jul 22, 2008)

We are currently using Encoder Pro to help us determine if a code is a bundled procedure but some codes are listed as expectable to bill with a modifier.

Example is 24305-51 was paid by Pacificare but the 64718 was not.

Is there a reference book out there that would help us define better what is bundled and what is not?

Also, was that paid correctly?


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## dmaec (Jul 22, 2008)

The CCI Edits will help you - link below:
http://www.cms.hhs.gov/NationalCorrectCodInitEd/

Also, the modifier would go on the 64718 (not the 24305) -


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## Lisa Bledsoe (Jul 22, 2008)

mowalker said:


> We are currently using Encoder Pro to help us determine if a code is a bundled procedure but some codes are listed as expectable to bill with a modifier.
> 
> Example is 24305-51 was paid by Pacificare but the 64718 was not.
> 
> ...



Do you have the Orthopedics Global Service Data books?  They are expensive but from what I recall contained information about bundled procedures.


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## KJ21 (Jul 22, 2008)

we also use orthopaedics comprehensive guide for Upper spine and above and for Lower Hips and below.


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## FTessaBartels (Jul 23, 2008)

*Modifier due to two arms*

The reason the modifier would be allowed is that you have two arms. So, one procedure could be performed on the left; the other procedure on the right.  But if you are talking about surgery on only one arm, then 64718 is considered bundled into 24305.

Since you added the -51 modifer on 24305 in error, double check that your reimbursement is what it should be.

F Tessa Bartels, CPC


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