patient had a cardiac cath and the CPT code provided by the facility is 93458. I have a stmt with a charge for this code along with separate charges for supplies. Is the facility unbundling these charges? thank you
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Tag Archives: Unbundling
Unbundling Question
I have a quick question regarding unbundling of a trigger finger release:
Here’s the OP
Right long finger incision
A number 15 blade was used to incise the skin overlying the A1 pulley of the right long finger.
Meticulous hemostasis was obtained in the subcutaneous plane. The flexor sheath, the A1
pulley, the flexor tendons, and the radial and ulnar neurovascular bundles were all identified and
protected. A 69 beaver blade was then used to incise the A1 pulley in its entirety. Following
the release, the patient did not demonstrate any evidence of catching or locking with passive
range of motion of the right long finger.
Of note, the patient had a significant amount of synovium surrounding both of the flexor tendons
to the right long finger. This synovium appeared hypertrophic and inflamed. As such, a
tenosynovectomy was performed for both of the flexor tendons
The right long finger wound was then copiously irrigated with sterile normal saline and the skin
was re-approximated with 4-0 nylon sutures. Attention was then turned to the right ring finger.
Physician feels that he has documented enough to bill for 26055 with 26145. Tenosynovectomy are inclusive in 26055 and I don’t feel his documentation is sufficient.
Help!
Thanks
Heather
Is Separate Coding of Services Unbundling or Correct Coding?
If appropriate rules and system edits are in place, exclusionary modifiers are the link to unbundling liability. Unbundling is a commonly asserted but often misunderstood fraud theory, even by coding experts. When evaluating potential unbundling as a fraud theory, it’s important to differentiate when separate reporting of services is simply correct coding and when it […]
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