Wiki 30465 and 30520

[efuhrmann]

Are these 2 codes bundled per your experience? I have 2 sources I use to check edits. Encoder says they are not bundles. The other source says they are and modifier not allowed. Just curious if anyone knows how United, Cigna, the Blues or Aetna would process?

 

[MARTIN#45]

I would bill them as 30465 and 30540, with a mod 59. You would get paid higher rate for the 30645. If required I would add a 51 to the 30540 as my second procedure.

30465
30540 59

30465
30540 51 59

Not sure about the all insurance policies but for the most part they should be fine with it.

Lisa

 

[jackjones62]

As of 2010, CPT 30520 and 30465 are no longer bundled, but do understand that 30465 is a bilateral procedure and if you only perform 30465 unilaterally you must append modifier 52; this happens to me quite often; as far using modifier 59, yes, I still use it as I don't trust the insurance companies, sometimes their coding edits don't reflect current CCI Edit changes and such.

Jennifer
CT ENT