DEC 15, 2016
Understanding Bundling Edits
Question: When I look in the Academy’s Coding Coach: The Complete Ophthalmic Reference, it shows that CPT code 66984 Cataract extraction with IOL has a Correct Coding Initiative edit bundling in CPT code 67005 Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal. However, when we look up 67005, there is no bundle. Should we not bill both codes?
Answer: When checking CCI edits, you must look at every code combination.
Because 67005 is bundled into 66984 and does not fit any of the indications to unbundle, submit only the code with the highest allowable for the particular payer.