Wiki Hand/wrist bundling

[sienamt]

One of my ortho docs wants to perform a thumb CMC arthroplasty (25447) and a proximal row carpectomy of scaphoid, lunate. triquetrum, pisiform (25215) on the same hand and in the same surgical session.
25447 and 25215 are bundled but I think I can use -59 to unbundle since they are separate procedures and separate incisions? Thoughts?

 

[Orthocoderpgu]

Can be unbundled

For the CMC arthroplasty the removal of the trapezium is included since that is part of the procedure. If a different carpal bone is removed, and has separate pathology, then that can be billed with a modifier. Removal of the other carpal bone must have separate and unrelated pathology in order for it to qualify to be billed separately.