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Claim Denial with Modifiers 24/58
I have been getting denied for office visits (99212-99215) billed during a global period. I bill the E/M code with a modifier 24, and/or 58 and the claims still get denied for “separately billed services/tests as they are considered components of the procedure. Separate payment is not allowed.” According to the conferences I have attended for KZA, we’ve been told that we can bill and E/M code with modifier 24, but the insurances do not cover it. Do you have any other suggestions on how to get these claims paid?
Wart Destruction with Liquid Nitrogen
A saw an established patient who I say for evaluation of a wart on the arm. The wart is moderate in severity. I evaluated the wart, performed a skin exam and removed the wart with liquid nitrogen and told the patient to come back PRN. My coder tells me I can only report the wart destruction and not a visit code. Is that correct?
Two Procedures on the Same Day
If a patient develops complications from a procedure later the same day as the original procedure and needs to return to the OR would we append modifier 78 or 79?
Decision for Surgery: Always a Level Five?
If the surgeon documents the decision for surgery and places the standard risk paragraph for that surgery, is this automatically a high level of risk?
Same Group Coding
The Interventional Cardiologist can generally bill an E/M (Evaluation and Management) service during the 90-day global period of a procedure performed by the Electrophysiologist in the same group — but only if certain conditions are met and modifier 24 is applied correctly.
Facet Wedge?
Our surgeon used a facet wedge device at C1-C2 and then performed facet arthrodesis with instrumentation. How would I code the facet wedge?
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