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Venkataraman Posted Mon 21st of August, 2017 17:46:04 PM
Example: Patient had a biopsy (88305), with the a KI-67 (88360) and Pan-Melanin (88342) performed. We are receiving payment on the 88360. However the 88342 is denying as "payment included in other procedure". Is a modifier required for the 88342? If so, would it also be required for any subsequent 88341?
SuperCoder Answered Tue 22nd of August, 2017 01:59:19 AM

Hi,

As Per NCCI edits, 88342 and 88341 does require the 59 modifier when billed with the 88360.

Hope that helps!

 

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