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modifiers and codes you can bill together

Rana Posted Mon 21st of October, 2019 08:07:45 AM
is it true you cannot bill only medicare using 15823 50 59 with 67900 50 51? i need to bill bilteral 15823 with 67900 bilateral and 67908 bilateral. how do i do that with medicare
Rana Posted Mon 21st of October, 2019 08:08:47 AM
what modifiers do i use and will mediare come back and audit and recoup if i bill bleph with 59 to unbundle with 67900
SuperCoder Answered Tue 22nd of October, 2019 04:00:13 AM

Hello Rana,

Thank you for your question.

 

Please find below the response for your queries:

 

is it true you cannot bill only Medicare using 15823 50 59 with 67900 50 51?

You can report CPT® codes 15823 and 67900 with modifier 50, as they have a modifier indicator “1”, which means 150% payment adjustment for bilateral procedures applies. Also, per NCCI edits, there are no bundling conflict between both the codes.

 

As there are no bundling between the codes, you need not to append modifier 59 with 15823.

Append modifier 51 with code 15823; as by rule, modifier 51 is appended to the code with lower RVU.

 

i need to bill bilateral 15823 with 67900 bilateral and 67908 bilateral.

As per CCI edits, there are bundling conflict between codes 15823 and 67908. Code 15823 is a column 2 code for 67908.

If both the procedures (15823 and 67908) are performed on the same eye and during the same session, then do not report code 15823.

 

Hope that helps!

Thanks

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