Open appendectomy (44950) + laparoscopic appendectomy (44970)
Open and laparoscopic approaches are mutually exclusive — choose based on actual procedure.
Why this pair bundles
Different surgical approaches; cannot perform both for same appendectomy.
Modifier-bypass policy
Modifier indicator: 0 — no modifier bypass is permitted for this pair under any circumstance.
No bypass. Choose based on approach. If laparoscopic converts to open, report only 44950 (open) per NCCI conversion rules.
Documentation requirements
- Operative report documents approach
- If conversion, note time and reason
Common clinical scenarios
- Conversion from laparoscopic to open during procedure
Frequently asked questions
Why does CMS bundle 44950 and 44970?
Different surgical approaches; cannot perform both for same appendectomy.
What documentation supports separate billing?
Operative report documents approach; If conversion, note time and reason.
When does this conflict typically arise?
Conversion from laparoscopic to open during procedure.
Sources
Catch NCCI 44950/44970 conflicts before submission
ApprovalHelp auto-flags NCCI bundling conflicts on the claim line before you submit. Modifier-bypass eligibility checked against current quarterly NCCI tables. no setup fee.
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