ollielooya
True Blue
RE: bundling with CPT codes 20610 and 64418
Hi specialists, and although I've had only one response from submitting a more detailed question to the general forum, thought I'd try this forum and rheumatology to see if there are any that know the answer. I know AAPC frowns on cross-coding posts, but really need some input.Without supplying chart notes just want some general input for my studies.
If these 2 codes (20610 and 64418) are billed together, NCCI edits indicate a bundling relationship--a modifier can over-ride (if appropriate) & would apply to 64418. However both 20610 & 64418 were performed in the same area (shoulder), so which modifier might be appropriate, 59 or XU? Dr. does not usually perform these 2 procedures together as 64418 suprascapular block is for pain control and for this particular patients case, each code has it's own separate dx code. Therefore, what reason might these 2 procedures be unbundled when performed in same area & what modifier would be a better choice? Still trying to determine if XU might be a valid choice.
I'm just trying to ascertain from a general perspective as I do not yet have the notes if there ARE cases where procedures performed in the same area with different dxs might qualify for bypassing the edits...
Hi specialists, and although I've had only one response from submitting a more detailed question to the general forum, thought I'd try this forum and rheumatology to see if there are any that know the answer. I know AAPC frowns on cross-coding posts, but really need some input.Without supplying chart notes just want some general input for my studies.
If these 2 codes (20610 and 64418) are billed together, NCCI edits indicate a bundling relationship--a modifier can over-ride (if appropriate) & would apply to 64418. However both 20610 & 64418 were performed in the same area (shoulder), so which modifier might be appropriate, 59 or XU? Dr. does not usually perform these 2 procedures together as 64418 suprascapular block is for pain control and for this particular patients case, each code has it's own separate dx code. Therefore, what reason might these 2 procedures be unbundled when performed in same area & what modifier would be a better choice? Still trying to determine if XU might be a valid choice.
I'm just trying to ascertain from a general perspective as I do not yet have the notes if there ARE cases where procedures performed in the same area with different dxs might qualify for bypassing the edits...