maudys
Networker
In the ED, if a foley is inserted and an EKG or infusion is done, i get the following edits. Is it appropriate to use a modifier -59 on these to clear the edit? See below:
You have coded 51702 in addition to the following code(s):
(36400, 36405, 36406, 36420, 36425, 36430, 36440, 36600, 93000, 93005, 93010, 93040--93042, 93318, 94002, 94200, 94250, 94680, 94681, 94690, 94770, 95812, 95813, 95816, 95819, 95822, 95829, 95955, 96360, 96365, 96372, 96374--96376, 99148--99150).
The Medicare NCC edits consider this separate reporting of codes that are components of the comprehensive procedure if billed for services provided to the same beneficiary by the same physician on the same day.
These codes will be rebundled by your Medicare payor and payment will be based on code 51702 only.
* If these codes represent a different session, surgery, site, lesion, or injury, then use of an appropriate modifier on the excluded code will differentiate the services provided and will notify the payor to bypass this edit.
You have coded 51702 in addition to the following code(s):
(36400, 36405, 36406, 36420, 36425, 36430, 36440, 36600, 93000, 93005, 93010, 93040--93042, 93318, 94002, 94200, 94250, 94680, 94681, 94690, 94770, 95812, 95813, 95816, 95819, 95822, 95829, 95955, 96360, 96365, 96372, 96374--96376, 99148--99150).
The Medicare NCC edits consider this separate reporting of codes that are components of the comprehensive procedure if billed for services provided to the same beneficiary by the same physician on the same day.
These codes will be rebundled by your Medicare payor and payment will be based on code 51702 only.
* If these codes represent a different session, surgery, site, lesion, or injury, then use of an appropriate modifier on the excluded code will differentiate the services provided and will notify the payor to bypass this edit.
