Billing > Facility Billing

Billing 11721 with 11055 or 11056

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Medicare is bundling these codes and shouldn't be.  Any suggestions on how they should be billed.

I am not a coder but since these are podiatric codes,  Medicare only pays under certain circumstances.. Relating to certain diagnoses such as diabetes, peripheral neuropathy etc. I would check the guidelines on your MAC site. 

I bill for six podiatrists in four different MAC's, and each of those MAC's will only pay if each code has a 59 modifier on it. This is in addition to have proper dx's, Q modifiers if needed, and LDS if needed.

I have tried to bill with the Modifer 59 and it was denied for invalid modifier.

It's really hard to tell without all of the info in front of us.  We don't know dx's, dx pointers for each code, and any modifiers billed.


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