1. User id : 32970 Posted 9 months ago #
   

   What modifier is appropriate for these two seperate codes? I don't feel 59 is appropriate because its not a different session & its not on a different body organ site. Both procedures are performed at same session & same eye however, different reasons...cataract & Glaucoma. Cahaba has split the charges & paid for the 66984 however, denied the 0192T CO16 - Claim/service lacks information which is needed for adjudication. Assuming they need op notes or modifier besides the LT ?

2. SuperCoder Posted 9 months ago #
   

   Hi Angela,

   Medicare needs the progress notes and operative notes to do a manual determination on payment. A modifier is not the problem.

   Thanks

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