Medical Billing Forum
Coding => Coding => : jennifer8055 October 22, 2013, 02:57:44 PM
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I am having issues with Medicare and code 29540 for padding/strapping.....basically kinesio taping. Recently Medicare states that you can only bill one unit per day of this code, what if the patient has bilateral feet/ankles done? I always bill the code twice - once w/a RT modifier and the second w/an LT modifier. Medicare states there's not an LCD w/any information on this, it's only listed on the MUE list (medicare unlikely edits). The reps from Medicare can only tell me to reference that and it will tell me what additional modifier needs to go on there. That "list" reads like something out of the Matrix movie.......just lists of 1's and 0's that really don't make any sense.
*****Can someone please let me know if they've had any experience w/this code and if so are you billing it RT and LT w/a -51 modifier or just one unit and no modifier? I may be doing alot of corrected claims to Medicare.....*****
THANK YOU !!
Jenn :)
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You had me doing research on this one and I am stumped. What did come up consistently was using an acceptable diagnosis code..which I am sure that you know since you have been doing this. I checked the AAPC boards but they did not discuss a bilateral procedure. Can you call your MAC? They should have a podiatric specialist that you could perhaps talk to.
Merry
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Did you try a 59 modifier on the second one? Separate site?
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I called our MAC today and the lady researched while I was on the phone w/her. She said as of 4/1/13, CMS guidelines state that 29540 can only be billed 1 unit per dos, but there's no LCD for this (?????). I asked about refiling w/modifier -51 or -59 showing separation and she said, based on the verbage, it doesn't look like it would really matter, it's 1 unit per dos and that's it. The only thing she suggested is changing our price, based on the allowed amount/fee schedule. Gonna get with my doctors and see what they want to do on this one......stay tuned.
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should be billed with modifier 50 x 2 units
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