Wiki Modifier issue

[shorteep]

Hi
I could really use someone's help. I have a patient that had surgery on 9/20 and had to return back to the OR on 10/20 due to
more debridment for pressure ulcers and also for flap advancements. Patient has had extensive surgeries almost on a weekly basis.
Insurance is humana and I keep getting denials for all the surgeries as modifer or (s) are invalid. I am billing all the surgeries
after the 1st with modifiers 78,59, & 76 if I have a repeat procedure
and 2nd scenario for code 15738 (billed 6 lines due to the (size) I billed 78,LT,59,76 what am I doing wrong.

 

[mk2001]

Hi
I could really use someone's help. I have a patient that had surgery on 9/20 and had to return back to the OR on 10/20 due to
more debridment for pressure ulcers and also for flap advancements. Patient has had extensive surgeries almost on a weekly basis.
Insurance is humana and I keep getting denials for all the surgeries as modifer or (s) are invalid. I am billing all the surgeries
after the 1st with modifiers 78,59, & 76 if I have a repeat procedure
and 2nd scenario for code 15738 (billed 6 lines due to the (size) I billed 78,LT,59,76 what am I doing wrong.

I'm not sure what all exactly is being billed but I usually bill a 78 or 58 modifier (related procedure/desired outcome was not accomplished with the first procedure) for related procedures.
The Medicare 76 modifier fact sheet that I have says it should not be attached to a surgical procedure code.