sinman0531
Guru
Hello all,
I have a denial from Humana for 17108-76 for a port wine stain. This destruction was performed within the global period of the previously performed 17108, and we generally get the code paid with a modifier 76, however today its denying as inclusive. I don't see how billing the exact same procedure is "unrelated"(-79), because its the same procedure for the same diagnosis in the same spot, but its not exactly a staged procedure or planned (58), because the provider doesn't always know how many sessions the patient will need. How do I get this paid?
I have a denial from Humana for 17108-76 for a port wine stain. This destruction was performed within the global period of the previously performed 17108, and we generally get the code paid with a modifier 76, however today its denying as inclusive. I don't see how billing the exact same procedure is "unrelated"(-79), because its the same procedure for the same diagnosis in the same spot, but its not exactly a staged procedure or planned (58), because the provider doesn't always know how many sessions the patient will need. How do I get this paid?