jennifernelson20
New
Do I need LT or RT modifier with thoracentesis? I know i need mod 25 on the visit if inpatient or same day as office visit, but I'm getting a new denial for the wrong modifier........
I did not use the LT/RT, but it was suggested to me. I have never needed a modifier either thats why im so confused. what i billed for that day was 99232 w/ 25 mod and 32555. nothing else. I will see if i can find someone to help me with the payer policy stuff. i cant remember which insurance it is, but its either Humana or United Healthcare.So you used LT or RT and got a denial? Are there any other services you're billing for on that day?
I don't recall that I've ever used laterality modifiers on thoracentesis and, since they're informational, I wouldn't expect a denial. I'd expect the payer to ignore it if I submitted and they don't need it. Have you checked the payer website for a policy that might be related to the denial? It's like a reimbursement policy, rather than a coverage policy but that depends on the insurance company.
We started getting denials for the same reason from different insurances that never needed an anatomic modifier before. Now, if a 50 modifier is allowed on a code, we attach LT or RT modifiers. Bilateral surgery is allowed for 32555.I did not use the LT/RT, but it was suggested to me. I have never needed a modifier either thats why im so confused. what i billed for that day was 99232 w/ 25 mod and 32555. nothing else. I will see if i can find someone to help me with the payer policy stuff. i cant remember which insurance it is, but its either Humana or United Healthcare.