Wiki Can I bill 45300 with 46221?

[SydGerman]

In the past we have billing the Banding & Procto with modifier -XU and got paid for both CPT lines. Recently, we have been getting denied for bundling and only getting paid for the Hemorrhoid banding. Wondering if there is a different way to approach this as our provider almost always does the Proctoscopy when doing the banding to ensure correct placement. Any comments would be helpful. Thanks in advance.

 

[sandra1]

Per the National correct coding initiative If an endoscopy or enteroscopy is performed as a common standard of practice when performing another service, the endoscopy or enteroscopy is not separately reportable.

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html