• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki 67113, 67228

Create Wiki
C

colleen.rettig@carle.com

New
Messages
2
Best answers
0
I have a doctor that is charging 67113 and 67228. These charges are bundled. His argument is he is fixing a retinal detachment, but doing photocoagulation on a separate part of the eye, away from the detachment. Can I add a mod 59 and send this thru? thanks!
 
Since 67228 is being done at the same time as 67113 on the same eye, my opinion is that it is not truly a "distinct procedural service" and -59 is not appropriate. Since the codes are bundled, what I would recommend is adding a -22 to 67228 and appeal with the op report for higher reimbursement on the basis that the service provided was greater than that usually required.
 
You must log in or register to reply here.
Top