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Wiki 31231 & 31237 same day but different encounters

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nlbarnes

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Per CCI edit, 31231 & 31237 cannot be billed together. The provider saw the pt in the a.m. and performed 31231 and later in the day had to come back for 31237. Could you bill this with modifier 59 and appeal if denied?
 
nlbarnes said:
Per CCI edit, 31231 & 31237 cannot be billed together. The provider saw the pt in the a.m. and performed 31231 and later in the day had to come back for 31237. Could you bill this with modifier 59 and appeal if denied?
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Yes, that's what I would do, though modifier XE would be more specific if the payer will accept it. I would expect a denial even with the modifier in this situation so I imagine you will likely have to appeal.
 
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