Wiki bundling qustion 43632 and 38100

[Kris78]

Is 38100 considered part of 43632?

CCI edits has a (1), but i was told 38100 is bundled in with 43632.

I have not found anything in writing yet that confirms that.


Any help/direction on this would be appreciated.

thank you!

 

[CodingKing]

38100 follows the standard "separate procedure" rule:

If the code descriptor of a HCPCS/CPT code includes the phrase, “separate procedure”, the procedure is subject to NCCI PTP edits based on this designation. CMS does not allow separate reporting of a procedure designated as a “separate procedure” when it is performed at the same patient encounter as another procedure in an anatomically related area through the same skin incision, orifice, or surgical approach.

If it meets the criteria for separate reporting you would need to add the appropriate modifier.