Teresa Posted Wed 22nd of June, 2016 09:08:22 AM
Received a denial on a claim billed as
26608/XS (Amerihealth for insurance)
patient had percutaneous fixation of the ring and long finger for metacarpal fracture..
I know cpt code has a MUE of 26608 so are we suppose to bill 26608 with units of 2?
Should we have used a 59 modifier?
SuperCoder Answered Thu 23rd of June, 2016 09:21:58 AM
CPT code 26608 should be submitted with anatomical modifier.
If surgery is performed in :
Left Hand - F2, F3
Right Hand - F7, F8 should be appended.
Hope this helps!
Teresa Posted Thu 23rd of June, 2016 14:53:20 PM
Just a quick followup question to your response........I guess I am a little confused to why finger modifiers would be used since the metacarpals are technically bones that are located in the hand and not the phalanges? I thought modifier 59 would have been the way to go. Is there a reference site that I can't be directed to?
SuperCoder Answered Fri 24th of June, 2016 06:35:51 AM
According to CPT code 26608, the operation is performed on the metacarpal. Metacarpal can be billed using the F modifiers because each metacarpal identifies to a unique finger there are 5 metacarpals in each normal hand.