• 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 Codes 23930 and 23931

Create Wiki
H

hockeychic

Guest
Messages
1
Location
Hamilton, NJ
Best answers
0
We billed these two codes together with a 51 modifier on code 23931. The insurance company paid this code but denied 23930 as incidental. Code 23930has the highest RVU and they are mutually exclusive, so we feel it should be paid as the primary procedure. We appealed the denial and they are upholding their decision. Any thoughts as to whether we should try a second level appeal for this?
 
There is a CCI edit in place so a 51 modifier will not override that edit. A 59 modifier would be needed if documentation supports billing of both codes.
 
You must log in or register to reply here.
Top