The code 28230 is for a tenotomy of the foot, not the toe. Therefore, you don't use T modifiers with that code, which is what is causing the denial issue. Tenotomy code for toe(s) is 28232. While you can use the 28230 for a tenotomy that will correct an issue with toe(s), the surgical incision is on the foot itself, thus no T modifier is applicable. Also, when you use two modifiers on a claim line, always put the one affecting the payment first, such as the 59. Then informational modifiers go second(T mods, RT, LT, etc). And yes, you bill multiple tenotomies in one session.