Wiki Modifier Help - Physician examines

[cyrucats]

Here is the scenario:
Patient comes in for post op follow up of left shoulder arthroscopic rotator cuff repair.
While in the office, patient mentions to physician that his right shoulder is painful. Physician examines shoulder, decides to inject with meds for pain relief.

We billed a:
20610-RT-79
J3301
J1094
99214-24-25

The payer denied the E/M code stating that the Chief Complaint specifically states "post op".

Help. Shouldn't this be paid?

Thanks, Cyndi

 

[Walker22]

Your chief complaint should have stated "post-op for left shoulder with new complaint of pain in right shoulder"