Wiki Modifiers and Global Period Question

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Hi,

I'd be grateful if someone could help with billing question. Patient has had prior procedures and is in global period. On the next visit two procedures will be performed. I'd like help determining the appropriate modifiers and their placement Would this be correct?
99214 24, 25
17000 79
17003 79
19000 59 79
J3301


Many thanks!

Sharon
 
daedolos said:
You shouldn't have to use modifier 25 if you are using 24.

Peace
@_*
Click to expand...

NEVER seen that as a problem with any carrier.

One is to indicate a separately identifiable E/M from the procedures being billed on that day. And one is unrelated to the prior procedure that started the postop period. Two different modifiers that tell the carrier two unique edits to over-ride.
 
Mohs and modifier 59

Thank you.

I have another derm/modifier question. If you'd be so kind to look at this as well?

When billing mohs surgery cpt codes 14040 (repair), 17311 (stage 1), 17312 (stage 2) to commercial insurance, do any of the codes require a modifier 59?


Happy Thanksgiving!


Sharon
CPC-A
 
No. None of those are bundled together

Here you will also see that 17311 will get reduced by 50% due to the multiple surgery reduction rule due to the presence of modifier 51. You don't need to add modifier 51. Most carriers will add it for you appropriately.

quickcheck.jpg
 
Last edited:
Thanks for the tip on 51. That's good to know! But actually, we're curious about whether 59 can be added.

Really appreciating your input!



Sharon CPC-A
 
I did answer in the previous reply. Please re-read

None of those codes are bundled together according to the National Correct Coding Initiative, so modifier 59 (or XS) is not needed and should not be added.
 
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