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Wiki Medicare says stents are duplicates???

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mbprzychocki

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Sebring, FL
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I have First Coast Service for Medicare and they are denying our claims because the stent codes are duplicated. A service rep told our billing office that we needed to put the "repeat" modifier (#76) in addition to the branch mod. Has anyone been having this problem?
Example:
93458-26,59
92928-LD
92928-LM

They will pay one of these and I have ended up putting a 59 on the other stented artery. I just didn't feel the "repeat" modifier #76 was appropriate, but then I feel I'm over using the 59. Any suggestions?

Thank you,
Mary Beth Przychocki, CPC
 
We have been using the 59 modifier. It is not a repeat procedure so I would not use the 76 modifier. First Coast LOVES to make the providers appeal everything. We have had to appeal a few but have also been paid for a few. It seems like it is up the the discretion of the person who gets the claim at First Coast.
 
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