HELP 11755 denied for wrong modifer-Nail Bx Dermatology

LBernat7

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We have gotten a denial from IBC 2 times now for "wrong modifier" on 11755
billed charges were
99213 OV for Full Skin HX of MM etc 25 modifier(went thru and paid)
11755-bx of nail (billed with 59 modifier and denied then billed without modifier as suggested and denied.)

So what modifier would you use
 

twizzle

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11755 modifier

We have gotten a denial from IBC 2 times now for "wrong modifier" on 11755
billed charges were
99213 OV for Full Skin HX of MM etc 25 modifier(went thru and paid)
11755-bx of nail (billed with 59 modifier and denied then billed without modifier as suggested and denied.)

So what modifier would you use
Interested to know why you put modifier 59 on 11755 in the first place. If this was the only procedural code then it can't have an edit and so modifier 59 is incorrect.

11755 likely needs an anatomical modifier such as F1 or T6 or whatever to indicate which finger or toe was biopsied. Was this a true biopsy though? Tissue from nail plate, bed, nail folds etc. This seems to be a code that is grossly overused.

Anyway, which code is correct is not your issue. Put an anatomical modifier on 11755 and you should be good.
 
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