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*DERMATOLOGY MODIFIER QUESTION

Medical Posted Fri 26th of September, 2014 10:07:05 AM

Billing Scenario #1
11406 DX 216.5
12032 DX 216.5
17004 DX 702.0
99213-25 DX 692.9, 702.0

Billing Scenario #2
17284 DX 173.0, 173.30
11402 DX 216.6, 216.5
12031 DX 216.6, 216.5

which modifier do we use 59 or 51 and on which code?

SuperCoder Answered Mon 29th of September, 2014 09:51:54 AM

Thanks for your question. For billing scenario 1, per CCI edits you would bill modifier 59 for both 11406 and 12032. They are column two codes for 17004. For billing scenario 2 CCI states to bill modifier 59 with 12031 as it is a column two code for 17284. Hope this helps.

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