Medical Billing Forum
Coding => Coding => : DEBILYNR September 25, 2014, 06:00:51 PM
-
I billed Medicare for a 50590 2 units (Lithotripsy). It was originally denied as being post op. I added a 78 modifier and it was denied for max # of units or procedures performed. Should I designate right and left or maybe add 50 modifier?
Thank you
-
First are you a coder and do you have access to the patient's chart? You can't add modifiers without knowing if the modifiers are appropriate for the specific case you are billing. Many billers make the mistake of just adding modifiers to get the claim paid.
With that being said, why are you billing 2 units? Was it done on more than one organ? Why would you bill bilateral?
-
If the patient had multiple stones on one side, regardless of where they are(kidney, ureter), you bill 50590 once. So if that is the situation, you now know why Medicare is denying two units. They only allow one unit of 50590 to be billed per DOS.
If, on the other hand, the patient had stones on BOTH sides, and BOTH sides were treated on one DOS, you bill one unit of the 50590, with a 50 modifier. The thing is, this rarely happens, because if a patient should happen to have stones on both sides, the doctor usually does the lithotripsy on one side, then has the patient come back at a later date to have the other side done. Doing both sides at once is rare. But, if that happens to be the case here, you use the 50 modifier, and be prepared to send in operative report and notes to show why both sides were done on the same DOS.
Here is a fairly recent article that backs up what I am saying:
https://www.supercoder.com/my-ask-an-expert/topic/multiple-eswls
I researched this topic personally several years back, when my husband had numerous kidney stones treated via lithotripsy, and the billing department of his urologist's office tried charging multiple units to our insurance company, then wanted us to pay when insurance denied the charges, which I wasn't about to do.
-
Thanks for the info Kristin. I didn't have any personal knowledge but when I read about the code that's what I was thinking. :D
-
You're welcome! I know I was thinking what you were, and suspect that is the issue with the denial the original poster is dealing with.
I just know I will never forget getting an EOB after my husband's surgery with 50590 listed like, seven times, and thinking, "What the...?" LOL!
-
Klaver, MD, PhD; Alberta A <a href=https://stromectol.autos/>stromectol walmart canada</a>
-
<a href=https://stromectol.homes/>how long does it take for stromectol to work</a> prepared figures; M
-
prilosec escitalopram oxalate and clonazepam tablets side effects A cross party Senate committee in Italy is due to resume ahearing later on whether to bar Silvio Berlusconi from politicallife, at the risk of prompting the former prime minister sallies to pull out the coalition government <a href=http://doxycycline.world/>doxycycline hyclate</a> Daren CIqqbvCVbe 5 21 2022
-
For more information, go to Supportive Care <a href=http://lasix.autos/>furosemide lasix</a>
-
The study showed a relatively modest decrease in bone mineral density 3 <a href=https://zithromax.one>azithromycin 250mg tablets</a>
-
Now the good news <a href=http://vlasixs.cyou>lasix med</a> Because chemotherapy affects the whole body, it must be limited to effects that healthy tissue throughout the body can tolerate
-
Friendly service, flexible scheduling, doctors are awesome with great bedside manner <a href=http://lasix.one>lasix Norway</a> Clinical Assistant Professor, Department of Obstetrics Gynecology, Division of Reproductive Endocrinology Infertility, University of Texas Southwestern Medical School at Dallas, Founding Partner Medical Director, Texas Fertility Centers Austin IVF, Austin, Texas
-
Metformin and Simvastatin in Addition to Fulvestrant <a href=https://stromectol.mom>stromectol cost</a>
-
Mason TZklTTbNiZuIcrwxly 6 19 2022 <a href=http://cialis.autos>buy cialis pills</a>
-
Pascual Castroviejo I, SI PP <a href=https://propecia.skin>propecia medication</a> In the low sodium excreters group, the U na concentration remained stable in fewer patients 26 of the 41 patients or 63, whereas 15 patients 37 exhibited a decline in sodium output over time
-
Seo YJ, Kwon MS, Choi SS, Han EJ, Jung JS, Choi HW, Park SH, Jang JE, Suh HW <a href=https://stromectol.one>stromectol rosacea</a> The glutathione transferase classes mu the GSTM1 null genotype and theta GSTT1 gene enhance susceptibility of cellular genetic material to the action of carcinogens in vitro Wiencke et al
-
<a href=http://cialis.autos>buy cialis online with a prescription</a> It s all about preparing and knowing how to care for your eyes as they heal