Circumcision

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6
Location
Coastal Coders
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0
Blue Cross and Blue Shield of South Carolina will not pay for a circumcision done on the same day of any e/m code although the e/m is coded with a 25 modifier. Even our appeals are denied by this carrier. Has anyone has any luck with appeal denials on the circumcision procedure? Has anyone had the same problem with other carriers?

99238 (25) V30.01
54150 V50.2
 

ebredehoeft

Networker
Messages
50
Location
Portland
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0
From my understanding you wouldn't be able to bill an E/M visit with a Circumcision. Wouldn't that be part of the surgical package?:cool: I have some doctors that are wondering the same thing.
 

Kirstyn20

Networker
Messages
38
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0
We always bill a wellness visit with our circumcisions, and have no problem getting paid (I am in Idaho). Most claims will be billed as:

99381-25 V20.2 (or 99391 if est)
54150 V50.2

Hope this helps!
 

ebredehoeft

Networker
Messages
50
Location
Portland
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0
Yeah after thinking about it some more I agree. If the patient was there for something other than just the circumcision you could add a 25. That makes sense. :)
 

terkim_98

Contributor
Messages
11
Location
Rome, GA
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0
We actually do bill the same way you do (99238 (25) V30.01
54150 V50.2) and I've not seen any denied. However, in some cases the circ charge will go to the patient's ded.
 
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