Author Topic: Podiatry billing question  (Read 68 times)

brendab

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Podiatry billing question
« on: December 05, 2017, 10:21:59 AM »
I am trying to bill28230 T6 59 & T7 59 claim denied for procedure code inconsistent with modifier used.
my question is  should I have billed this right foot Qty 2 or can you only get paid for one of them.
Thank You

Michele

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Re: Podiatry billing question
« Reply #1 on: December 06, 2017, 09:47:28 AM »
Are you billing that on one line with 4 modifiers?  Or two lines with 2 modifiers each?  Are there any other codes on the claim/same date of service?
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kristin

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Re: Podiatry billing question
« Reply #2 on: December 12, 2017, 03:17:20 PM »
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.

brendab

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Re: Podiatry billing question
« Reply #3 on: December 13, 2017, 03:00:29 PM »
Thank you