Wiki cysto and treatment codes

[jhutchens]

Hello,

physician insists 52310 and 52332 were performed as two separate procedures...medicare guidelines show these are bundled...have tried using
59 modifier..still same denial ..any suggestions?

 

[puppymom2]

I know they list 52310 as a separate procedure, but since the stent was basically being replaced I'm pretty sure you can only use 52332. I always hated those "how things should be paid" vs. reality discussions with my docs. ;-)

 

[Grintwig]

Were the procedures performed on two separate sites?
If so you may need to send the procedure notes to Medicare to get paid.

 

[jhutchens]

no ..it was one site

 

[jhutchens]

Ok. Thank you...that's what I thought