Wiki Dermatology

[knalley2]

I am working on some Medicare Dermatology claims. It was billed with 11302 and 11302-59. Is there a better way to code this to get reimbursement? Medicare is denying the first 11302 without a modifier for a duplicate.

 

[medipro5]

That is the way we bill it to show it is a separate lesion. We have no problem with getting paid from Medicare.
Deb

 

[b.cobuzzi]

I would recommend using the XS modifier for Part B medicare and for any payers that recognize the “X” modifiers. Because payers are suspicious of modifier 59 usage as unbundling to be paid, usage of the X[ESPU] Modifiers to payers that recognize these modifiers such as Part B Medicare, United Healthcare and Horizon (NJ) BCBS. Go to your payer’s website and research the modifiers they acknowledge and you can determine if they accept the “X” modifiers.