Wiki 28010/28011

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solocoder

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Can someone take a look at these codes and tell me what is the correct way to bill multiple units of 28010 to Medicare? When I bill it on multiple lines with appropriate toe modifiers, they deny it. But they always pay multiple units of 28011 when I bill it the same way. ???
Any ideas?
 
Revenue Coordinator/Coder: CPC

Looking at the codes individually, you cannot use units with code 28010; it's one or the other it seems to me. 28010 is for only one/single tendon and 28011 is used for more than one/multiple tendons which can be billed in units with toe modifier.
 
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Per Margie Vaught, 28010 is for tenotomy of 1 tendon in one toe and should be billed for each toe with toe modifiers. 28011 is for tenotomy of multiple tendons in one toe and should be billed for each toe with toe modifiers.
Other payers pay both of these codes in multiples, it's only Medicare I have had a problem with.
 
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