Billing 11750 , 11730 and 11732

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Billing multiple procedures for a NC Medicaid patient that has denied twice. I am thinking it is something to do with the modifiers and maybe instead of grouping the toes on the same Line Detail each one should be an individual Line Item? :confused: Any help or guidance would be great. Following is how we billed:

11750:TA
11750:T5:51
11730:51:T1:T6
11732:51:T2:T7
11732:51:T3:T8
 
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Billing multiple procedures for a NC Medicaid patient that has denied twice. I am thinking it is something to do with the modifiers and maybe instead of grouping the toes on the same Line Detail each one should be an individual Line Item? :confused: Any help or guidance would be great. Following is how we billed:

11750:TA
11750:T5:51
11730:51:T1:T6
11732:51:T2:T7
11732:51:T3:T8

11730 bundles with 11750 and 11732 is an add-on code to 11730. With 11732, there should be units used instead of individual line items for each add'l nail plate. There shouldn't be a need to include the anatomical mods for 11732 because the description already indicates "each additional nail plate", aside from the fact that add-on codes aren't supposed to have mods attached. For 11730 (which carries down to 11732), there really isn't any other option besides a 59 mod here because there's multiple sites involved.

I'd probably lean more towards:
11750-TA
11750-T5
11730-59
11732 x 5

As far as the 51 mods - Because these codes all have an indicator of 2 for mult proc, Medicare doesn't recommend adding a 51 as the logic to reduce the price is already included when ranking them. However other payers might require it, so you'd have to check with MD to find out if they want you to include it or not.

You'll want to make sure you have all the appropriate DX codes to identify multiple toe injuries and that the diagnosis pointers match up.
 
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Thank you

Thank you for your response as Medicaid can be a tricky insurance. Your reply and insight is greatly appreciated. :)
 
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