Wiki coding modifier help ...please!

eferris

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this scenerio was billed out for one of our patients


92004/25
68761/RT
68761/LT


The patient then came back 7 days later complaining of pain and itchiness (forgive the spelling) and the doctor rebilled the same scenerio. I cant decide what modifier to use for these codes. I hesitate to put the 24 on the 92004 since she is comming in for a complication of the procedure. the modifiers i have come up wtih for the 68761 are either 58, 78, or 76. Any other sugestions? Any help would be greatly appreciated.
 
Your original encounter was billed correctly. After the patient came back 7 days later, it is not clear what the Physician did for the patient other than a visit. CPT code 68761 has a post op period of 10 days. You would not bill for a complication from the code in this period. If the patient came back for something unrelated to the code in the post op period such as a laceration you would use an established patient CPT code such as 92012-24 with the 24 modifier. Hope this helps.
Sharon
 
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