DecisionHealth, DecisionHealth - 2023 Issue 9 (September)

Here’s why the AMA and CMS seem to disagree on bundling of hip arthroscopy codes

Question: Medicare’s National Correct Coding Initiative (CCI) includes a code pair listing CPT codes 29916 and 29915 as mutually exclusive procedures, but allows you to unbundle the edit with a modifier. But the AMA says not to report the two codes together. Any explanation as to why CMS and the AMA conflict on these codes, other than that CMS is sometimes at odds with the AMA and private payers?

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