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modifier ?

Rana Posted Wed 26th of February, 2020 13:15:05 PM
codes 67882 and 67917 are column codes and needs to be unbundled. im billing 67882 first do i put 59 mod with it or on the 2nd line? also where do i put 51 mod?
SuperCoder Answered Thu 27th of February, 2020 07:53:02 AM

Hello Rana,

Thank you for your question.

 

As per CCI edit, CPT® code 67882 is a column 2 code for 67917, but you may use a CCI-associated modifier to override the edit under appropriate circumstances. So, append modifier 59, with code CPT® code 67882 basis your detailed medical documentation.

 

Per CMS, when same physician performs more than one surgical service at the same time, modifier 51 is appended to the surgical procedure code with the lower physician fee schedule amount. So, in that case fee for CPT® code 67882 is $581.04, so append modifier-51 with this code CPT® code 67882.

Coding example:

  • 67917
  • 67882-51,59

 

Note: Kindly get in touch with your payer for modifier 51 specific reimbursement guidelines as some payers don't reimburse when modifier 51 and 59 are appended together.

 

Hope that helps!

Thanks

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