Medical Billing Forum
Coding => Coding => : ellie June 13, 2012, 09:40:54 PM
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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.
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Hi Ellie!
I am doubting if CPT 23443 is an active code. What service are you trying to bill for, using that code?
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the codes are
23470 LT
23430 51LT
THIS IS HOW IT WAS BILLED. 23430 51LT DENIED FOR M80
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Could you give the denial reason? The denial code doesn't really help.
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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.
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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.
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Yes! Absolutely right. Please make sure you use an alternate diagnosis code that is available on the charts. Thanks.