• 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 Cpt 79005

P

prabha

Guru
Messages
191
Best answers
0
Can we append modifier 59 with CPT 79005??
 
Sorry, I have enetered the question incorrectly...My question is, can we append modifier 26 to CPT 79005, because my provider says that we cannot seperate this procedure as proffessional and technical component..
 
Ahhh....well that makes more sense however the provider is mistaken. This CPT can be billed with a 26 or TC unless you are billing globally. The national Medicare Fee Schedule has this CPT broken down in Global allowable, Professional allowable, & Technical allowable as well which only further proves that this code is reimbursed separately.

Do you think that maybe it was denied to POS/TOS edit? Or that the other billing company, either the facility or the physician since I do not know which you are billing for, may have submitted the code without a modifier which would have made the insurance company reimburse them as a global charge and deny your claim?
 
You must log in or register to reply here.
Top