Paula Posted Thu 19th of March, 2015 15:34:36 PM
Hello..I need some help. Our patient had knee surgery in September. Patient returned in October for wrist sprain. This is what I billed for the wrist visit.
Insurance denied 29065 59,79
Is 29065 billable with the office visit or am I not using the correct modifier.
Center For Orthopaedic Surgery & Sports Medicine
SuperCoder Answered Fri 20th of March, 2015 09:36:51 AM
This procedure code 29065 does not have any billing restriction with office visit. However, it is not allowed to be billed with CPT 20605 unless you use a modifier. You may also need to check with the payment policy/reimbursement policy of the payer as well.
Paula Posted Fri 20th of March, 2015 16:16:51 PM
WHICH CPT CODE ARE YOU REFERRING TO THAT NEEDS A MODIFIER. THEY BOTH HAVE MODIFIER.
CENTER FOR ORTHOPAEDIC SURGERY & SPORTS MEDICINE
SuperCoder Answered Mon 23rd of March, 2015 04:10:52 AM
Most payer does not pay for casting/splinting/ strapping CPT code for the same site as an injection or aspiration, even if you use a modifier, which is most likely a reason why the insurance company denied the CPT code 29065 when it was billed with a 20605 (wrist joint injection) CPT code.