Wiki 36902 & 36558 denying

[cherylbr]

We have recently received a denial from Medicare for 36902 being billed with 36558 & 76937 all done on the same day. 36558 & 76937 paid however 36902 kicked for pre/post-operative care payment is included in the allowance for the surgery/procedure. The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.
I am confused as I am not seeing any bundling issues. Is anyone else having this same denial?

Thank you!

 

[Jim Pawloski]

We have recently received a denial from Medicare for 36902 being billed with 36558 & 76937 all done on the same day. 36558 & 76937 paid however 36902 kicked for pre/post-operative care payment is included in the allowance for the surgery/procedure. The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.
I am confused as I am not seeing any bundling issues. Is anyone else having this same denial?

Thank you!

You have two different procedures coded, so you need a modifier -59. Was 36558 for a dialysis catheterization?

HTH,
Jim Pawloski, CIRCC