Need Assistance

KathyJMiller

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I am new to orthopedic billing and need some assistance. We have billed a 27886 and 11044. This is the 2nd return to the OR during post op due to re opening of patient incision. Medicare denying 11044 with denial reason of pre/post operative care payment is included. Below is how we billed it. Is this not correct or should we be billing different modifiers?

27886,79,RT
11044,51,59,RT
 
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209
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Massapequa, NY
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you are saying brought back to the OR, but your modifier indicates its not related - if its really not related 11044 should be billed with just a 79 as well, no site modifiers for this cpt code and 27886 and 11044 are ok to be billed together so no need for modifier 59, if it is related or staged instead of not related, (you will know this by asking the doctor) then 78 or 58 would be added. hope this helps
 
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