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MEDICARE AND PROCEDURES

Rhonda Posted Wed 31st of July, 2013 20:04:18 PM

: ok the patient has medicare and our doctor billed a biopsy,excision and blood draw same day. So I used modifier 59 on the biopsy, the biopsy and blood draw was payed. I can't figure out the modifier for the excision. Also, a month later the doctor did another excision on a different spot on the patient, I added modifier 24 but it was still denied. What can i do? Thanks, Selena Redmond

SuperCoder Answered Fri 02nd of August, 2013 15:04:08 PM

I am a bit confused about How Biopsy and Excision are coded together for the same day. Could you give me description of procedures and codes used ?

Thanks,

Rhonda Posted Mon 05th of August, 2013 20:43:15 PM

OK, 11644 WITH DX CODE 173.32, 11100 WITH DX CODE 238.2, THEN HE DID THE BLOOD DRAW. MODIFIER 59 WAS USED ON PROCEDURE CODE 11100 WHICH WAS PAID ALONG WITH THE BLOOD DRAW. THE EXCISION (11644) WAS DENIED.

THANKS

Rhonda Posted Mon 05th of August, 2013 20:44:10 PM

sorry for the all caps, wasn't paying attention

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