Wiki C Section only with 58611

[Crik]

Is anyone having issues getting these two codes paid? I am getting denials stating the required modifier is absent. The 58611 is an add on code and doesn't require a modifier. Help please.

 

[Bready]

C section only with 58611

Add modifier 59 to 58611. CPT coding guidelines may say this is an add-on code- no modifier needed- but I have found that many carriers insist on the modifier for the claim to be paid. We have to play by their rules. Good luck.

 

[russoatteberry2005]

If it is a Medicaid payer depending on your state you may need a MODIFIER UB or UC as is the case in the state of Georgia you do not need to attend a modifier 59 to58611