Coding > Coding

36415 Bundled

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cturner75:
Yes, I tried locating information under LCD & NCD, but couldn't find anything. 
An office visit was also billed.  We did a blood draw to send to the lab, and also a urinalysis.  Which we do often in our office.
Thanks-

cturner75:
I should also clarify that the insurance rep was the one who informed us that 36415 was bundled with 81003, not the office visit.

Michele:
Is Caresource a Medicare replacement plan? 

I think at this point I would file a written appeal asking for an explanation of the denial.  My main argument would be that it is not appropriate to bundle 36415 with a urine test, 81003.  Include information as to what the 36415 was performed for. 

Good luck!
Michele

Chodges:
36415 is probably bundling with the E&M and there is a CCI edit out there for that.  If documentation supports an office visit then you can add mod 25 to the E&M.

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