1. Karen H
   Posted 4 months ago #
   

   billed medicare cpt 62311 mod 79 and cpt J1040 dx 847.2. the modifier was due to a appt one month prior where patient had office visit CPT 99213 mod 25 and CPT 17000. medicare reject codes are CO-50 (non covered services) ,M25 (information does not substantiate level of service), N115 (decision based on local coverage determination). We have billed this in 2010 and prior without any problems. We don't bill for this very often.

2. SuperCoder
   Posted 4 months ago #
   

   As I understand from the given question:
   1st Visit(1 month back): 99213-25 and 17000
   2nd Visit, now: 62311-79
   *
   The global period for CPT 17000 is 10 days. As 62311 being performed beyond global period, so no need of using modifier 79 with 62311 as being performed outside global period, need no modifier with 62311.

3. Karen H
   Posted 4 months ago #
   

   the above billing was my second attempt to medicare - I added the mod 79.
   my first billing was CPT 62311 with no modifier. That first billing rejected due to M25 and N115 (see above descriptions). How should I try to bill for a third time?

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