Wiki Cpt 41874 help

[mmunoz21]

I have a claim and op note for 41874 x3 quadrants...provider billing 41874, 41874-59 and 41874-59...

The description of code states EACH quadrant, so does 59 apply or does 51 apply?????

 

[pkulczycki]

Hi,

I am not sure what state you are in; however, here is the link to a National Coverage Policy I found on the Michigan website: http://wpsic.com/medicare/part_b/policy/dent002.pdf

I am going to give you another link below. I think the way you identify the quadrants as stated in the CPT book is with your ICD-9 codes. Read the information in the following link and you will see what I mean. I do not feel modifier -59 or -51 are needed because the code is telling you to specify the quadrants.

Here is the other link: http://www.aaoms.org/docs/practice_mgmt/coding_papers/alveoloplasty_with_extractions.pdf

Read the ICD-9 codes and you will get what I am saying about identifying the quadrants with the diagnosis codes.

Peggy Kulczycki, CPC, CPC-I