lbusby2
Networker
Okay, I need some help. Should their be a modifier attached to the 69436, other than bilateral when these are done at some surgical session?
42830 (Adenoidectomy)
69436-50 (bilateral Tympanostomy (requiring insertion of ventilating tube).
Problem: EncoderPro says need modifier 51 to 69436, but these are 2 different organ systems, so wouldn't 59 be more appropriate.
Also, if you go to CMS CCI code edits, these 2 are not listed together?
Help. Claim is being denied when modifier 59 is being added to 69436.
Please add rationale..Thanks
Lynn
42830 (Adenoidectomy)
69436-50 (bilateral Tympanostomy (requiring insertion of ventilating tube).
Problem: EncoderPro says need modifier 51 to 69436, but these are 2 different organ systems, so wouldn't 59 be more appropriate.
Also, if you go to CMS CCI code edits, these 2 are not listed together?
Help. Claim is being denied when modifier 59 is being added to 69436.
Please add rationale..Thanks
Lynn