Wiki CCI EDITS, Is this strictly for Medicare use?

bench

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Hi Fellows,

As I was reading on the posts here, I noticed that there are lots of questions regarding billing cpt code 29877-59 with 29881 or 29880. A lot is saying that they are getting paid with 29877 and others are not or using the code G0289 in place of 29877 for professional claim. Others are also saying that only medicare is not paying this and other payers does, that they don't have problem with 29877 payment. My point here is, do we have something like a guidelines about this. A lot of other payer now is using the Medicare CCI edits as their reference. Like Aetna or United Health Care, if they see that the coding is bundled according to CCI, they will not pay the other code as in this case 29881 with 29877-59. Blue Cross used to pay this separately and now our claim is also getting denied as inclusive or bundled. I would like to appeal this but since CCI edits said its bundled they might go back to our previous claims and pull out other paid claims to us as overpayment. When we do something like this with Blue Cross they are asking for other claims that we got paid on as reference and they may say that they processed the other once incorrecly. Any advise? Thank you very much.
 
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