Medical Billing Forum

Coding => Coding => : ellie June 13, 2012, 09:40:54 PM

: MULTIPLE PROCEDURES
: ellie June 13, 2012, 09:40:54 PM

 IF THE NCCI EDITS STATE ONE MODIFIER ALLOWD AND I HAVE MULTIPLE PROCEDURES HOW WOULD YOU CODE THIS ?

23470 LT
23443 51 LT

MCR DENYING PAYMENT FOR 23443 51 LT

SHOULD I TRY 23470 LT
                      23443

THANKYOU FOR YOUR HELP.

: Re: MULTIPLE PROCEDURES
: Sriram_Sub June 14, 2012, 11:25:24 AM

Hi Ellie!

I am doubting if CPT 23443 is an active code. What service are you trying to bill for, using that code?

: Re: MULTIPLE PROCEDURES
: ellie June 14, 2012, 09:59:55 PM

 the codes are

      23470 LT
 
      23430 51LT

      THIS IS HOW IT WAS BILLED.  23430 51LT DENIED FOR M80

: Re: MULTIPLE PROCEDURES
: Michele June 18, 2012, 12:19:13 AM

Could you give the denial reason?  The denial code doesn't really help.

: Re: MULTIPLE PROCEDURES
: Sriram_Sub June 18, 2012, 11:32:46 AM

M80 stands for "Not covered when performed during the same session/date as a previously processed service for the patient". May be you can try billing with 59 Modifier (Distinct Procedure) and try projecting a different diagnosis code (if available on the operative notes) for the second procedure. Not very sure if this sorts out your issue. But just thought of throwing an idea. Please do reply if you try this and get the claim paid.

: Re: MULTIPLE PROCEDURES
: Michele June 19, 2012, 02:18:31 PM

Please be careful though.  It is fraudulent to change coding strictly to get a claim paid.  You must make sure that the coding matches what was done and what is in the patient's chart. 

: Re: MULTIPLE PROCEDURES
: Sriram_Sub June 20, 2012, 08:37:12 AM

Yes! Absolutely right. Please make sure you use an alternate diagnosis code that is available on the charts. Thanks.