tci Outpatient Facility Coding Alert - 2013 Issue 10

Reader Question: Don't Try to Split 28296 and 64450

Question: I billed 28296 for a bunion correction with metatarsal osteotomy, and 64450 for the peripheral nerve block. The payer denied my claim saying 64450 was incidental. Can I use a modifier to get paid separately for this? Georgia Subscriber Answer: You have two things to consider for use of a modifier: 1. Did the physician operate on separate sites? 2. Did he perform the nerve block for a separate procedure? Heads up: The National Correct Coding Initiative (CCI) has bundled nerve blocks into bunionectomies since 2002. These edits have a status indicator of “1,” however, meaning...

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