Author Topic: Bundled Charges  (Read 1635 times)

RMHN

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Bundled Charges
« on: October 18, 2010, 10:08:59 AM »
I need help when billing 29805-Shoulder arthroscopy. Our surgeon also wants to bill 23130 and 23120. What modifier can be used to get all three procedures paid? This is for a medicare patient. Thanks!

Michele

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Re: Bundled Charges
« Reply #1 on: October 18, 2010, 11:24:05 AM »
Modifiers cannot be used strictly to get a claim paid.  They must be warranted by the services performed.  The only way you can tell if they would be warranted is by either getting them from the provider or a coder looking at the patient's surgical notes. 
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RMHN

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Re: Bundled Charges
« Reply #2 on: October 18, 2010, 05:17:06 PM »
I have read the reports and it does appear the additional codes should be considered.  The patient  actually has medicaid, not medicare and i was under the impression Medicaid does not accept modifier 59. (wyoming medicaid)

Michele

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Re: Bundled Charges
« Reply #3 on: October 19, 2010, 07:07:13 AM »
I'm not familiar with Wyoming medicaid.  The states I have billed do accept the 59 modifier but the 51 modifier may be more appropriate for what you have described.
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oneround

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Re: Bundled Charges
« Reply #4 on: October 19, 2010, 10:54:40 AM »
Is this a subacromial decompression?    Because depending on how the chart reads the 29805 could be included in the 23130 and not able to be billed with a modifier if a repair was done.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare