Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Coding)
Incidental Procedures Incidental is defined as a procedure carried out at the same time as
a primary procedure, but is clinically integral to the performance
of the primary procedure, and therefore, should not be reimbursed
separately.
11-26
An example would be billing the following procedure codes
together:
59300 .....Episiotomy
59409 .....Vaginal delivery
An episiotomy performed as part of the overall management of a
delivery does not warrant a separate identification. This would
result in the line item denial of procedure 59300 and would be the
participating network provider’s responsibility.
Another example would be billing the following procedure codes
together:
44005 .....Enterolysis (lysis of adhesions, separate procedure)
44140 .....Partial colectomy with anastomosis
Services that are identified by CPT with the term “separate
procedure” are commonly carried out as an integral component of
a total service. Separate procedures are not reported in addition to
the total procedure or service of which it is considered an integral
component. This would result in the line item denial of procedure
44005 and would be the participating network provider’s liability.
When this edit is applicable, the following message(s) will appear
on your current remittance advice:
This procedure is incidental to another procedure processed
on this or another claim.
This procedure is incidental to the primary procedure.
Reimbursement is included in the allowance for that primary
procedure.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (07/12/12)