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?
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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!