Wiki 58662

[klapetri@ilovemygyn.com]

OB/GYN-NY

Does 58662 require modifier RT or LT?

We billed insurance 58662 with modifier RT

Healthfirst requesting refund stating invalid modifier used?

Please help

 

[SharonCollachi]

I would ask them for their medical policy in writing regarding this code. It's such a petty reason to request a refund, as you're giving them more information, not putting a modifier on it to try to unbundle or get more reimbursement.

 

[csperoni]

58662 is the same whether unilateral or bilateral. No modifier is required. That being said, it's absurd to request a refund after they already paid, when all you did was supply additional information. But that's HealthFirst for you.

Interestingly enough, 58661 is the opposite. -50, -RT, -LT are all valid and required.

 

[klapetri@ilovemygyn.com]

We are receiving refund request for cpt codes
58660 bundled with 58662
58660 bundled with 58661

 

[csperoni]

I think you posted this question twice.
58660 is a column 2 (never allowed) CCI edit for both 58661 and 58662. The insurance should not have paid separately for 58660 in the first place.
If the lysis of adhesions are significant (> 1 hour) and described in the op note, I bill the primary procedure with -22 modifier and prepare an appeal letter.