Wiki 29888 with 29881

[paroberts]

I am still a student in the AAPC but I work for Orthopedic surgeons and there claims are coming back stating they can not bill these codes together

 

[cstoldt]

According to the CCI edits 29888 (primary procedure) can be billed with 29881. Did you apply a modifier to 29881? It will need modifier depending on your carrier 51 or 59.

 

[mitchellde]

it depends on the documentation as to whether you can bill with a modifier, it is not a CCI edit so that you can always use a modifier, it is a CCI edit because there are times when the 2 codes cannot be billed together so it is possible depending on the documentation.

 

[juneh]

I bill for an ASC, I do not see them as bundled, nor requiring a modifier. Can you post the denial? I looked at my past few months I billed several and not one of ours have denied.

 

[dclark7]

These codes can be billed together, however you need to make sure that your diagnoses are linked properly. You wouldn't do a menisectomy for an ACL tear, so if your diagnosis is not correct it could be denied for medical necessity. It would help if you posted the denial reason.

 

[mitchellde]

You are correct. I did not find it as an edit in the latest edition of the CCI edits. I always assume the poster has checked this when they post that it is a CCI edit. Apologies.
Therefore it did not deny due to a CCI edit, what exactly does the denial state?