New to general surgery.....and I have a question. We do a lot of colonoscopy's and EDG's. They often do both procedures during the same session. For example, In the same surgical session the doc did a 45380 due to 569.3, 211.3 and 562.10 and a 43239 due to 535.10. I added a 59 modifier to 43239. I received a Medicare(WV) EOB today and they added the modifier 51 to the 43239 and only allowed 86.55. The allowed amount for a 43239 is 173.09. The reduced the allowed amount by $86.54. Is this right? This does not make since to me! But...again I'm new to general surgery.
The did they same thing to the codes below:
19125, 38525 and 38792 - They added a 51 to 38525 and 38792 and reduced the payment.
I just want to make sure I am not missing something! If I can get full reimbursements for both procedures, especially the 45380 and 43239, please let me know! They do that a lot!
Thank you so much!