Wiki 58565 with 64435

[natfos6]

new to ob/gyne coding. Insurance carrier is stating 64435 is bundled to 58565, is this something I can appeal with a modifier or do I need to write off?

 

[tpkeith]

According to ACOG, it is included in the procedure. NCCI column 2 Code Modifier Indicators show 'N' - following the CPT code indicates that there are no circumstances in which a modifier would be appropriate. The services represented by the code combination will not be paid separately.
Teresa Keith
North Georgia Women's Center

 

[Practice Coder2011]

new to ob/gyne coding. Insurance carrier is stating 64435 is bundled to 58565, is this something I can appeal with a modifier or do I need to write off?

58565 is not billable with 64435. you want to consider billing the primary procedure done. otherwise it will be denied.