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Wiki 58100 Endo Bx and 57500 Cervical Bx at same visit

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sfirth1

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Patient was seen for a problem visit in the office and needed to have an Endo bx done. During the Bx the provider saw a cervical polyp so a cervical bx was done as well. Anthem is denying 57500 stating "service is included in another service/procedure." I tried using modifier 51 to 57500 but still getting same denied reason. Any thoughts on using modifier 59 or should I appeal it?
 
Check your codes with the NCCI edits. You didn't give the endo bx code but it could be that NCCI edit rules out the use of these two codes together. If the codes are allowed together then try resubmitting corrected claim with modifier 59 "distinct procedural service". Send the op note too.
 
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