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Medical Billing Forum
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Bundled Charges
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Topic: Bundled Charges (Read 3318 times)
RMHN
Newbie
Posts: 2
Bundled Charges
«
on:
October 18, 2010, 01:08:59 PM »
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!
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Michele
Administrator
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Posts: 5927
Re: Bundled Charges
«
Reply #1 on:
October 18, 2010, 02:24:05 PM »
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
Newbie
Posts: 2
Re: Bundled Charges
«
Reply #2 on:
October 18, 2010, 08:17:06 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)
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Michele
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Posts: 5927
Re: Bundled Charges
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Reply #3 on:
October 19, 2010, 10:07:13 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
Full Member
Posts: 226
Re: Bundled Charges
«
Reply #4 on:
October 19, 2010, 01:54:40 PM »
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.
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Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare
Medical Billing Forum
Re: Bundled Charges
«
Reply #4 on:
October 19, 2010, 01:54:40 PM »
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Medical Billing Forum
»
Coding
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Coding
(Moderators:
Alice Scott
,
Michele
) »
Bundled Charges