We have a patient with a fracture and billed 27760 RT. Then later that day she was admitted Inpatient for a different diagnosis. We billed 27760 RT that day. When we received the admission documentation we billed 99222 25 99232and 99238. We are being rejected on our hospital charges. Have I coded correctly? Our office manager wants to put a 79 on it and I said that is the incorrect use of that modifier. Thank you for your help in advance.
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About this Question
- Posted by Chris Patterson 1 year ago. There are 5 posts. The latest reply is from Teresa Cooper.
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Have you billed 27760-RT both before hospitalization and after hospitalization as well ? If so, then its wrong coding. Plz provide info in the manner as below.
DOS & Code used before hospitalization:
DOS & Codes used after hospitalization: -
She came into the office and had a fracture so we casted and charged the global
10/13/10 27760-RT it went out electronically within 24 hours
When the documentation for hospital stay was complete we billed weeks later:
10/13/10 99222-25
10/14/10 99232-24
10-15-10 99238-24.We were paid for the 27760, 99232, and the 99238. Medicare rejected the admission 99222-25.
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In such a case, you should have billed 99222 with modifier 24 also, as the E/M service that you are billing is a care on same DOS, in Postop duration, even though unrelated.
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I think you are going to have a use a 24 on the 99222. Did you code an office visit on 10/13/10 along with the 27760-RT? I would try to appeal with the 24 modifier with the explanation that this was a different diagnosis.
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