Author Topic: 17110 DENIAL IN CONJUNCTION WITH 99214  (Read 5990 times)

joyce

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17110 DENIAL IN CONJUNCTION WITH 99214
« on: November 27, 2012, 01:51:32 PM »
Hello,

I have a patient who on 08/21/12 had a surgery with a global of 90 days.  On 08/31/12 she had another un-related surgery, therefore I billed it as shown below.

DX:  078.19
99214 (24)
17110

The carrier paid only the 17110 and stated that the 99214 is global to the 17110. 

Should I have billed the 99214 with modi 24 and 25?  I believe I should have done that, but I just wanted to make sure there is not something else that I should have done as well.

Thanks,
Joyce

Michele

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Re: 17110 DENIAL IN CONJUNCTION WITH 99214
« Reply #1 on: November 29, 2012, 01:53:13 PM »
I believe you need to use the 79 modifier on the 17110 to indicate:  Unrelated Procedure or Service by the Same Physician
During the Postoperative Period  and the 25 modifier on the 99214 to indicate Significant, separately identifiable evaluation and management (E/M) service by the same physician* on the day of a procedure.   Obviously this is based on information given, and I don't have access to patient's records to verify if that coding is appropriate.
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joyce

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Re: 17110 DENIAL IN CONJUNCTION WITH 99214
« Reply #2 on: December 05, 2012, 01:17:23 PM »
Thanks Michele!  I was able to get it paid with 99214-24 and 17110-79

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