jkottarathil
Contributor
Hello,
I'm not positive if this belongs in this category, but I wasn't sure where else to put it. I have a situation where the provider reported toenail debridement (11721) as well as a separately identifiable E/M (99336). The E/M service is definitely supported in the documentation. However, I don't believe the same is true for 11721. Neither a systemic condition nor a secondary code/condition (to use in conjunction with B35.1) is mentioned. I'm wondering is it more appropriate for me to remove CPT 11721 from claim as it would then be considered bundled with the E/M service? Or would it be more appropriate to append modifier GZ (an ABN was not issued so this is the more appropriate modifier to use) to 11721 and leave it on the claim? Any help is appreciated!
I'm not positive if this belongs in this category, but I wasn't sure where else to put it. I have a situation where the provider reported toenail debridement (11721) as well as a separately identifiable E/M (99336). The E/M service is definitely supported in the documentation. However, I don't believe the same is true for 11721. Neither a systemic condition nor a secondary code/condition (to use in conjunction with B35.1) is mentioned. I'm wondering is it more appropriate for me to remove CPT 11721 from claim as it would then be considered bundled with the E/M service? Or would it be more appropriate to append modifier GZ (an ABN was not issued so this is the more appropriate modifier to use) to 11721 and leave it on the claim? Any help is appreciated!