APPEAL LETTER TEMPLATE

Bundling / NCCI Edit Appeal Letter (Modifier 59)

Use this when an NCCI edit bundled a second procedure into the primary and both were genuinely separate. It wins on documentation of distinctness — separate site, session, or encounter — not on the modifier alone.

What makes it win

  • Prove the two procedures were distinct: different anatomic site, separate session, or a separate encounter
  • Support Modifier 59 (or the more specific X{EPSU}) with the operative/procedure note, not just the code
  • Cite the NCCI Policy Manual exception that applies to the code pair
  • Confirm the modifier is on the correct (secondary) line and the edit pair is separable (Modifier Indicator 1)

The template

Replace the [BRACKETED] fields with your details. This is the manual version of the appeal Volari files for you automatically.

[PRACTICE LETTERHEAD]
[DATE]

[PAYER NAME] — Appeals Department
[PAYER APPEALS ADDRESS]

RE: Appeal of Bundling / NCCI Edit Denial (CARC 97)
Patient: [PATIENT NAME]   Member ID: [MEMBER ID]
Claim #: [CLAIM NUMBER]   Date(s) of Service: [DOS]
Codes at issue: [PRIMARY CPT] and [SECONDARY CPT]

To the Appeals Department:

We are appealing the bundling of [SECONDARY CPT] into [PRIMARY CPT]. These were distinct services and [SECONDARY CPT] is separately payable with Modifier 59 (or [XS/XU/XE/XP]) appended.

The procedures were not components of one another: [DESCRIBE DISTINCTNESS — separate anatomic site / separate session / separate encounter, WITH SPECIFICS]. The NCCI edit pair carries Modifier Indicator 1, permitting a modifier when the services are separate, and the circumstances here fall within the NCCI Policy Manual exception for [CITE EXCEPTION].

The enclosed [operative/procedure] note dated [DATE] documents each service independently, including [DISTINGUISHING DETAIL: site, laterality, time, or session].

We request [SECONDARY CPT] be paid as a distinct procedural service. Please contact [CONTACT NAME] at [PHONE] with questions.

Enclosed: procedure note, corrected claim with Modifier 59 on line [LINE NUMBER].

Sincerely,
[BILLING MANAGER NAME], [TITLE]
[PRACTICE NAME] — NPI [NPI]   TIN [TIN]

Common questions

When should I use a bundling / ncci edit appeal letter (modifier 59)?

Use this when an NCCI edit bundled a second procedure into the primary and both were genuinely separate. It wins on documentation of distinctness — separate site, session, or encounter — not on the modifier alone. It addresses: Bundling denials — CARC 97 (payment included in another service), NCCI edit pairs.

What makes this appeal letter win?

Prove the two procedures were distinct: different anatomic site, separate session, or a separate encounter; Support Modifier 59 (or the more specific X{EPSU}) with the operative/procedure note, not just the code; Cite the NCCI Policy Manual exception that applies to the code pair; Confirm the modifier is on the correct (secondary) line and the edit pair is separable (Modifier Indicator 1).

Other appeal letter templates
Medical Necessity Appeal LetterTimely Filing Appeal Letter (with Proof of Timely Submission)Prior Authorization / Retroactive Authorization Appeal LetterE/M Downcoding Appeal Letter (Level Reduced)Non-Covered / Benefit Denial Appeal LetterCoordination of Benefits (COB) Appeal LetterCorrected Claim Cover LetterExperimental / Investigational Appeal LetterProvider Not Eligible / Credentialing Appeal LetterFrequency / MUE Units Appeal LetterGeneric First-Level Appeal LetterPeer-to-Peer Review Request LetterSecond-Level / External Review Request Letter

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