Wiki OV Mod

[torihamill]

Patient came in post op for left ingrown nail. She complained at visit of right foot heel spurl. Doc performed partial matrixectomy (11750-79). Doc also coded 99212-24 to Medicare IL. Notes clearly state the difference of the right and left problems and the procedure performed on the right foot.

Medicare denied the visit as bundled with the same day procedure. When I called Medicare they said I needed another modifier. I know that modifier 24 is needed so it doesn't bundle as post op but should I also add 25 to this code so it doesn't bundle with the same day procedure?

Thanks

 

[btadlock1]

Patient came in post op for left ingrown nail. She complained at visit of right foot heel spurl. Doc performed partial matrixectomy (11750-79). Doc also coded 99212-24 to Medicare IL. Notes clearly state the difference of the right and left problems and the procedure performed on the right foot.

Medicare denied the visit as bundled with the same day procedure. When I called Medicare they said I needed another modifier. I know that modifier 24 is needed so it doesn't bundle as post op but should I also add 25 to this code so it doesn't bundle with the same day procedure?

Thanks

You need both, actually. Bill it as 99212/2425.