Wiki Modifier help please

[jamiejohnson63@earthlink.net]

Where would I put a modifier and which modifier?

11602
12032
11900
J3301

THANKS

 

[ABonnell CPC]

12032
11602-59 so that this isnt bundled into 12032
11900- 59 or 51 depending on the payer. I have some payers that dont recognize mod 51.
J3301

 

[CatchTheWind]

The only code that needs a modifier is 11900, which gets a 59. (Neither the 11602 or 12032 needs a modifier, because excisions and repairs don't bundle with one another.)

(If you are billing to a payer that requires the 51 modifier, then you would add 51 to the 11602 and the 11900. I personally am not aware of any payers that require modifier 51 anymore.)

 

[ABonnell CPC]

I still have several commercial payers that still bundle the excision and intermediate closure codes together unless I do use mod 59.

 

[CatchTheWind]

Are you sure they aren't making a mistake? Modifier 59 should not be required, as these codes do not bundle.

 

[ABonnell CPC]

I just think a lot of times, there are edits on the various claim adjudication systems that don't always match correct coding, and it can be frustrating.