Forum - Questions & Answers

Jun 25th, 2010 - ssage

CPT 57456 and 58100

I received a denial for CPT code 57456 and 58100. I cannot find anything that states they cannot be billed at the same time. Do you have any information on billing these codes together?

Jun 25th, 2010 - TerryC 39 

57456,58100

Looking at page 203 current cpt book, states "code also endometrial sampling (biopsy) performed at the same time as colposcopy 58110" endometrial sampling performed in conjuction with colposcopy.

Jun 25th, 2010 - nmaguire   2,606 

CCI Edit

medicare has a CCI edit that prohibits code 58100 when code 57456 is also billed. The edit has a (0) modifier which means you cannot bypass to get paid. Remember CPT is not a reimbursement tool, it is a listing of codes. Insurers make reimbursement decisions.



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