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"64721 59"

Paula Posted Thu 03rd of December, 2015 13:21:21 PM

Hello, I have a question on a denial I received on cpt code 64721 59 and 29125 59. This is what we billed:
25609 Lt
25260 59
64721 59 denied
76000 26 59
29125 59 denied
Here is the procedures performed:

PREOPERATIVE DIAGNOSES:

1. Fracture, left radius.
2. Carpal tunnel impingement of the median nerve, left wrist.

POSTOPERATIVE DIAGNOSES:
1. Fracture, left radius.
2. Carpal tunnel impingement of the median nerve, left wrist.

OPERATIONS PERFORMED:
1. Open reduction and internal fixation of the left radius with volar Acumed plate.
2. Repair of pronator quadratus muscle.
3. Fluoroscopic control and splint application.
4. Left carpal tunnel release.

Is the denial on these two codes correct?
Thank You,
Center For Orthopaedic Surgery & Sports Medicine

SuperCoder Answered Fri 04th of December, 2015 06:52:24 AM

According to NCCI, Casting/splinting/strapping should not be reported separately if a restorative treatment or procedure to stabilize or protect a fracture, injury, or dislocation and/or afford comfort to the patient is also performed. Therefore 29125 should not be coded here with 25609. Code 64721 Neuroplasty and/or transposition; median nerve at carpal tunnel should not be coded with code 25260 Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle unless there is separate incision for both the procedures.

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