I mean, both eustachian tubes are being dilated so can I bill bilat?
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Tag Archives: Billed
Can 64708 be billed twice?
Once for radial nerve and once for PIN nerve [posterior interosseous nerve].
If the DX backs up each neurolysis?
If the DX backs up each neurolysis?
46607 billed with 46615?
Hi, everyone!
I’m reviewing our daily anoscopy charts, and I’ve never come across this scenario before. Patient presents for HRA with biopsy (46607) and has incidental warts removed from the anus with electrodessication. Provider coded the visit as 46607 and 46615. I’m assuming the 46615 was because of the electrodessication, but I don’t feel it’s an actual ablation of tumors, but just wart destruction. My gut says the visit should be 46607 (1 biopsy), and 17110-59 for the wart destruction.
What are your thoughts?
~Jen
Modifier for Dermatology Excisions and Repairs being billed together
As a general rule, and I correct in using -51 on the Excision code when both procedures are billed together in the same visit? Or should it be -59? I’ve been told either, but that doesn’t seem correct. Thanks for your help!! 
Post Op Pain Reimbursement – Payment for 76942 (x2) when billed with 64447 & 64448
I have billed Medicare (Novitas) for CPT 64447 WITH 76942 (Ultra Sound Guidance) and CPT 64448 WITH 76942 for POST OP pain after a Total Knee Replacement.
Modifier 26 is added to each CPT 76942 item listed separately on each line.
Modifier 26 is added to each CPT 76942 item listed separately on each line.
98% of the time, both 76942 codes are denied; 1 with denial code CO-151 (..excessive amt/frequency of services not supported) and the other with denial code OA-18 (duplicate services).
They are then submitted for reconsideration with the result being that only 1 pays and the other denies as a duplicate.
2 images are submitted for the 2 sites, however, the provider does his dictation for both procedures on the same procedure note.
I am looking for advice on how to get the 76942 codes to pay for both without having to appeal or suggestions for documentation to submit for successful appeal for both USG’s.
Question: What is the correct way to bill for TWO CPT codes 76942 (Ultra Sound Guidance) with 64447 (Adductor canal single shot injection for a pain block) and
64448 (Adductor canal continuous catheter pain block) when performed on a single patient?
Question: Do additional modifiers need to be submitted along with the modifier 26?
Thank you for your assistance.
Why would L8642 (hallux implant) be billed with a cranial procedure?
The HCPCS code L8642 for a hallux implant was billed with 61510 (removal of cranial lesion), +61781 (intra-operative work of stereotactic navigation for intradural cranial procedure), and +69990 (use of operating microscope). Since these are all cranial procedures (and no other work was done to any other body part) I’m wondering why the hallux implant was billed? I thought L8642 was an ortho code that would be used in the repair and/or reconstruction of the big toe. Was a mistake made here? (perhaps a code for cranial surgical mesh/filling should have been used) or does ‘hallux’ refer to something else other than the big toe? I’m a little confused.
Thanks!
Modifier need on a 93010 when billed with 99281-5
I am being told in order for a claim to go thru and get paid that 59 modifier has to be amended to the interpretation 93010 when also billing the ED EM code group 99281-99285. I just can’ t see why a 59 modifier has any bearing in this scenario. If any one can help with clarification on this is would be greatly appreciated
Closed Reduction W/o Manipulation Code Billed the Day Prior to ORIF
Good afternoon,
My orthopedic surgeon wants to bill for a closed reduction w/o manipulation code (24500) on 6/8 and bill for the ORIF (24515) on 6/9 (the following day). I advised the provider that all he did on 6/8 was assessed the condition and plan for surgery therefore, 24500 is not separately billable. According to the guideline I’m currently reviewing "if plan is for manipulative procedure at a future date, non-manipulative fracture management should not be billed" If however, "treatment is instituted, with the possibility for a manipulative procedure at a future date, bill non-manipulative fracture management". In this case, the provider already knew and planned for surgery the next day.
My understanding is that closed reduction codes without manipulation involve treating a fracture until is healed that’s why they carry a 90-day global day.
My provider wants me to add modifier 58 to the ORIF code but I think is inappropriate. I honestly think all he should be billing for 6/8 is the E/M code along with modifier 57 and for 6/9 bill for the ORIF.
Any opinions will be appreciated.
Thank you.
Z00.00, Z00.01, Z00.419 when billed with sick OV
Hi, everyone!
I’m seeing a lot of claims where my providers are seeing patients for a CPE or a Well Woman Annual exam, and they’re using 99201-99215 along with Z00.00, Z00.01 and Z00.419 as the primary dx. The payers are paying the claims as they are coded, for the most part. I’m wondering if this is allowable, and my only gripe is the money we’re losing out on by not coding 99385-99397? Is there documentation I can show my providers that says that this is not allowed?
Thanks!
63047 And 63267 billed in same op session???
I have a neurosurgeon who is trying to send through 63047 and 63267, different levels, same op session. My experience has been with carriers, even with a 59 modifier on 63047, they deny as bundled. Any suggestions or pointers on how to code this? Thank You.
L2-L3 Laminectomy for alleviation of epidural lipomatosis
L3-L4 Laminectomy with bilateral foraminotomies for removal of synovial cyst
L4-L5 Laminectomy with bilateral foraminotomies for severe central stenosis