Medical Billing Forum
Coding => Coding => : dtillotson April 26, 2018, 06:00:14 PM
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I have billed a visit as follows:
99213 w/ modifier 25 (linked with ICD B07.9 and L70.9)
11306 (linked with ICD B70.9)
17000 (linked with ICD B70.9)
Blue Cross Blue Shield has paid 99213 & 17000 but not 11306, with reason N19 "Procedure code incidental to primary procedure"
do I need to add a 59 modifier to it? or do I need to send an appeal?
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It depends on whether the two procedures were done on the same wart, or not. If it was the same wart, you can't bill both a destruction code and a shave code, either the wart is destroyed, or it is shaved. If it was two different warts, and one was shaved and one was destroyed, then you would need the 59 modifier. You may still need to send in notes to prove that it was two separate warts, though.
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It is two separate warts, thank you. I have added the 59 modifier, and am submitting it by paper with a copy of the notes and a reconsideration form.