Wiki CPT codes; 27447 and 27457

[0913@70]

If these two procdures are done on the same knee. Do you bill the CPT code 27457 with modifier 59 or 51.

We billed 27447 and 27457.51.

Medicare denied and per their rep if we correct and appeand modifier 59 to the CPT code 27457 they will pay. Is this correct? I ma thinking, same session, incision, organ it should be modifier 51. Any help is appriciated.

Thanks

 

[0913@70]

If somebody could help me with this I would appriciate it.
Thanks

 

[PatriciaCPC]

Please clarify

Hi!
27457 is inclusive of 27447, so I would not have billed for 27457 given the information provided.

When submitting a -59, documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or seperate injury.
Good luck!

 

[0913@70]

We have some insurance Companies paying with modifier 51, but I was confused when Mediare Rep stated that modifier 59 would be appropriate. I was thinking is payable since if is billed with modifer 51 since not everybody have dx of genu varus and like I said some Insurance Companies are paying for this cpt when billed with 27447 and Medicare also.

Thank you for your help