Wiki Debridement of Ulcer and Compression Dressing

[april.schneider]

I recently found out that Medicare will not pay for a 29581 (Application of Multi-Layer Venous Compression Dressing) if is it applied to the same leg with a Debridement of Ulcer - 11042. The frustrating issue is that the compression dressing has nothing to do with the ulcer. It is used by our doctor to treat edema or venous issues. I've tried using the 59 modifier but Medicare denies it.

Does anyone have any tips on how to bill this? Medicare will pay if the dressing is applied to the opposite leg.

Thank you!

 

[hewitt]

Apparently, it is possible that they would pay for these services. You have to meet medical necessity, and the place of service has to be allowed as well. Here is a copy of our LCD. It has been suspended, but will give you a direction to head in for your areas LCD or NCD. http://www.cms.gov/medicare-coverag...ontrVer=1&Date=&DocID=L27373&bc=iAAAAAgAAAAA&

 

[TiffanyParks]

Our office is paid by Medicare (CGS) when a 59 is applied to 29581. I have found that if a 59 is forgotten and the claim denies it will be denied again if the 59 is added and the claim just resubmitted. We then have to then appeal and the claim will be paid.