I am billing for a Lactation Consulting Group. They perform Frenectomy on infants often. We always billed 40819 and 41115, I started having issues when we tried billing for more than one tongue release. I would normally bill 40819 with only 1 unit, but if there are two releases I would use 2 units with a 50 modifer, it is being denied, and if I bill for three releases and use 3 units and a modifer 22 I am also getting denied. Can anyone provide me with information as to how to get paid when there is more then one tongue release performed. Thank you
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Wiki Frenectomy CPT 40819
- Thread starter AREDAR
- Start date
eagendj
Contributor
Even though the frenulum may be on both sides of the tongue, only one tongue is released so only one code would be coded.
kelee91
New
I am getting a denial on CPT code 40819 using diagnosis codes K13.0 (Thickened frenulum of upper lip) and Q38.0 (Congenital maxillary lip tie) . Can anyone help as to why I am receiving this denial?
We use dx code Q38.1 and are reimbursed by most insurance companies for 40819
OpenClaims
Guest
I would not report modifier 50 as their is only one tongue. I wouldn't report multiple units either in most instances.