Wiki 29876 and 29880

[pochranek]

So, we billed a procedure to Medicare showing CPT 29876 as the primary procedure and CPT 29880 as the secondary procedure based on the RVUs. Medicare flipped them on us and listed 29880 as the primary procedure.

Did something change that we are not aware of with the RVUs for these two codes?

Thanks for your help!

Peggy

 

[mray85]

The coding is incorrect. 29876 is a column 2 code to 29880. According to the NCCI manual, you cannot bill 29876 with 29880 due to the three-compartment rule. Also, 29875 cannot be billed with 29880 because of the (separate procedure) designation on 29875. The only billable code is 29880.

 

[Emmily63]

29876 is considered a separate procedure by definition, is usually a component of a more complex service and is not identified separately. When performed alone or with other unrelated procedures/services it may be reported. Since 29880 was performed, that needs to be the code that is billed as primary