Orthopedic Coding Alert
Bundling Options
Question: According to HCFA’s Correct Coding Initiative (CCI) guidelines, 29881 (arthroscopy, knee, with meniscetomy [medial OR lateral]) and 29877 (debridement/shaving of articular cartilage [chondroplasty]) are OK to bill together. Am I missing something? A -59 modifier is added to 29877 on each, and several diagnoses are given. We received from this carrier a company letter indicating their systems inability to pick up modifiers if they are sent electronically. I have dropped these claims to paper and have attached the CCI guidelines and operative report with the original submission and have not found any difference. Are there any important steps or problems we are missing?
Answer: There are many different bundling options, depending on the insurance company you are dealing with. Medicare uses the CCI, but commercial carriers have the option to use any bundling rules they choose. Many commercial insurance companies do not recognize separate payment for these two codes under any circumstances. You have followed up on this problem correctly. Just understand that if you are not dealing with Medicare, the CCI edits information may not change the interpretation of the proper use of these codes.
Jeff Sturgeon
Orthopedic Specialists
Dallas, TX
Orthopedic Coding Alert
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