Medical Billing Forum
Billing => Billing => : MBP April 19, 2010, 03:36:41 PM
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does anyone bill placing a port under fluoro? i am having the worst time with these claims, the radio guidance keeps getting denied. the codes i get from my doctor are: 36571, 75989/26 and 76000. i checked ncci and figured 76000 is bundled with 36571 and 75989 is bundled with 76000. i told this to my dr and she wanted me to apply mod 59.. i did, but still rejected.. does anyone know how to bill these together? i have tried to search online, but couldnt find anything even about billing 76000 and 75989 together.. ???
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Which code did you apply the 59 modifier to?
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i applied it to 76000 b/c it is bundled with 36571. it got rejected, i submitted again with 59 with both, 76000 and 75989, rejected, so i submitted with 59 on 76000 and 51 and 59 with 75989, b/c 75989 is bundled with 76000.. all rejected. running out of options, i thought i would ask for an advice here before sitting on hold for 45 mins when i call medicare..
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http://sz0013.wc.mail.comcast.net/service/home/~/CHAP9-CPTcodes70000-79999_final083109.pdf?auth=co&loc=en_US&id=43661&part=2
This is from CMS Claims Processing Manual. It has really good information in it. The manual is updated for 2010 - page IX-11. I found the whole thing interesting, but then again - I'm a dork ;D
I hope it is helpful to you. I'm not sure if the link will work. I hope so.
Brenda
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Dorks are what keep the world moving forward! ;D
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thank you both. it still doesnt help me find the answer. but it sure confirmed that you are a research guru Brenda! :)
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Here's what I get, is your documentation supporting the -59?
Code / Description
36571 INSERT PICVAD CATH M Rel Wt: 25.33
No bundling issues exist
76000 FLUOROSCOPE EXAMINATION M Rel Wt: 1.27
Code 76000 is a component of Column 1 code 36571 but a modifier is allowed in order to differentiate between the services provided.
Code 76000 is a component of Column 1 code 75989 but a modifier is allowed in order to differentiate between the services provided.
75989 ABSCESS DRAINAGE UNDER X-RAY M Rel Wt: 0.00
No bundling issues exist
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I have not seen the op report, I have got those codes from the MD, notified her of the rejections and she told me to bill it with -59. I explained how -59 works and she told me her report supports the use of it. so i billed it, but can't get the 3 of those paid together. from your info, -59 with 76000 and -59 with 75989 correct? that didnt work..
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-59 on the 76000 s/b enough. And they still denying the 76000-59 as still inclusive? Who is the carrier?