Maybritt Posted Mon 05th of February, 2018 10:40:10 AM
Regarding Repair of a Scaphoid for a Nonunion of the wrist 25440. Our edit shows 25430 as being bundled with 25440. However, Medicare states modifier 59 can be used. Under what circumstances can we unbundle these two codes?
SuperCoder Answered Tue 06th of February, 2018 07:23:37 AM
In the given scenario, CPT code 25430 would be included in 25440; as the insertion of vascular pedicle into carpal bone was performed for scaphoid bone non-union itself.
Note: The indications for pedicle VBG for scaphoid problems include non-union.
If the insertion of vascular pedicle procedure was performed on some other carpal bone(s) other than scaphoid bone, then it would have been billed separately.