multiple skin lesions scalp

[Alice Marshall]

My doctor excised 6 separate lesions from the scalp of a patient. 4 of the lesions were the same size. I was paid for the 2 lesions that were different sizes but rejected as duplicate the 4 that were the same size. I used a 51 modifier. Patient has Medicare. What should I have done?

 

[mitchellde]

My doctor excised 6 separate lesions from the scalp of a patient. 4 of the lesions were the same size. I was paid for the 2 lesions that were different sizes but rejected as duplicate the 4 that were the same size. I used a 51 modifier. Patient has Medicare. What should I have done?

You need the 59 modifier on the duplicate codes to show that they ate distinctly different procedures

 

[camcpc@yahoo.com]

How did you submit the code? Can not tell unless I see the codes and modifiers and the size for each lesions. camcpc@yahoo.com

 

[madcomic2000]

You should have used mod 59 on the extra codes that they denied as duplicate. Even then they will still probably deny and you will need to do a redetermination to submit records to prove they are different sites.