Cpt Code Help

dmaec

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in my opinion, it does - "radiologic examination;clavical, COMPLETE" ;) yaknow, dangit - I have to rethink this, I just spoke to one of our radiologists and she said, when bilateral is done, they take two separate (actually four because apparently they take two angles per side). So, I guess in that case, a modifier .50 on it should cover it all :)
 
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dmaec

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hmmm, I guess I'd disagree with that. I rarely use a .59 on xrays - sometimes, but rarely - and not in this instance.:)
 

mbort

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The purpose of the 59 modifier on the 2nd is due denials on the second line for duplicate (or whatever other reason they see fit). I've seen this over and over and since I started putting the 59 (seperate site) on the 2nd line, denials have diminished.

If you were to have a hammertoe 28285-T5 AND 28285-T6, you would have to put the 59 on the 2nd line (28285-59-T6).

X-rays are really no different :)

Then again, maybe its just an issue I have with the carriers I submit to.
 

dmaec

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yes, I see the indicator code is '3', which means you certainly can use the rt/lt on the 73000. (and apparently it should be reimbursed without multiple procedure fee reduction!)
:)
 

Lisa Bledsoe

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To further this discussion, I have just found out that TrailBlazer is denying our rt/lt xrays wanting mod -76 on one...what do you all think of that? Since mod -76 is "repeat procedure" and we are not repeating the procedure on the same site, that seems like an inappropriate modifier to me...:confused:
 
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