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Wiki Medicare Bundling

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JJ

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Pt was seen in IM office for CPT 99214 & 17000 on 6-21-11. Pt then came to urgent care (same tax id) for CPT 99214 & 12001 (laceration of the elbow). MEDICARE HAS BUNDLED BOTH CODES WITH 17000 (DESTROY PREMALIGNANT LESION) DONE ON 06/21/11 AND HAS A 10 DAY GLOBAL PERIOD. I tried mod 59, which did not work. Is there a modifier that will help us get paid? Thank you for your assistance.
 
I should have mentioned it was not the same Physician that saw the patient in Urgent Care. Thanks
 
No I think you should go with the 79 modifier on the second procedure. Even though these are 2 different docs they are in the same practice. So use a 24 and 25 on the second visit level and a 79 on the second procedure, see if it works.
 
Thank you for all the information. Debra, we are resubmitting with your suggestions. I will post an update on whether we get paid.
 
nhenderson, Thank you for your information, we are resubmitting with your suggestions. I will post an update. Thanks again.
 
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