In 1864, Anthony Trollope said, "Perhaps in no career has a man to work harder for what he earns, or to do more work without earning anything."  And this was before Relative Value Units and bundling edits!

There are commercial payers who do not use the National Correct Coding Initiative bundling edits, developed by Medicare, but instead use a third party software with their own edits.  You can recognize these edits because instead of using the word bundled on the denials, it will say the service was incidental to anther service.  Like heck it was!

It is impossible to fight these individually, on a claim by claim basis.  Appeals just trigger a second denial.  What can you do?

• Negotiate these out of future contracts, if you have the clout with your payer
• Contact your state medical society, the AMA, the banking and insurance department.  Find out if there are any actions taking place on behalf of physicians.  It was these types of actions that forced some commercial payers to recognize modifier 25, for example.