My doctor performed lumber puncture on the same day with hospital visit, i billed hospital visit 99233 with 96450 modifier 59 and got denied by medicare. Can those 2 CPT be billing together? 99233 got denied for bundle and 96450 got denied for missing/invalid/incomplete procedure. What did i bill wrong?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki lumber puncture with hospital visit
- Thread starter kathyle
- Start date
mhstrauss
True Blue
First off, 96450 is for chemo admin...is that truely what was performed? If not, LP codes are 62270-62272. Just asking because your original post doesn't mention chemo.
Secondly, for the denial, 59 wouldn't be appropriate because there is an E/M and a procedure involved, as opposed to 2 different procedures, in which case 59 may be appropriate. When you are looking at an E/M with a procedure, modifier 25 is appropriate, provided that the documentation supports the 2 separate services.
HTH!
mhstrauss
True Blue
Yes, chemo performed.
For what you advised,
I should had billed 99233 w/modifier 25 and 96450?
Thank you very much for your response.
Yes, I agree with this.
You're welcome!