Wiki circumcision and frenotomy

[sooloo66]

Hello -

I am reciving denials for the following claim that I submitted to insurance. Any advice on how to recode would be appreciated.

10/16/16 99460-25
10/16/16 41115
10/17/16 99462
10/18/16 99238-25
10/18/16 54150

This claim is for newborn services performed at the hospital. The circ (54150) was denied as being bundled. I did resubmit with a -24 modifier, but it still denied. Any ideas?

 

[Cynthia Hughes]

Denial of circ

Hello -

I am reciving denials for the following claim that I submitted to insurance. Any advice on how to recode would be appreciated.

10/16/16 99460-25
10/16/16 41115
10/17/16 99462
10/18/16 99238-25
10/18/16 54150

This claim is for newborn services performed at the hospital. The circ (54150) was denied as being bundled. I did resubmit with a -24 modifier, but it still denied. Any ideas?

Hi,

I see two things here. First, you state frenotomy was performed but have the code for frenectomy. Frenotomy is reported with code 41010 and like frenectomy, frenotomy has a 10-day global so because the circumcision is an unrelated procedure during the global period, I would recommend resubmission with modifier 79.

Hope that helps.
Cindy

 

[sooloo66]

Thanks!

I appreciate the suggestions