Cigna MC Advantage Denial for 45385-45380

[lamiller]

I am getting tons of denial stating C097(payment included in allow of other services) and N19 (procedure incidental to primary procedure) for CPT 45385 and 45380 billed together. Anyone else getting these denial so often? I am putting 33 modifier on 45385 and XS modifier on 45380. They are both different anatomical sites. I have done reconsideration with medical records and they are upholding their decision.