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Wiki Pilar Cyst Excision

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Staykey

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We had a pt that came in for removal of 2 pilar cysts on the scalp. One was located on the mid-frontal scalp & the other on the right central parietal scalp. We billed BCBSTX 11421-59, 11422, 12031 & 13120. Ins denied the 11421 for incorrect modifier. Any idea why they would deny that code with the 59 mod? TIA!!
 
They may be denying it because it is not needed. None of these codes look like they bundle. Each excision should be coded separately, and they only need a modifier if you bill the same cpt more than once.
 
dkb6126 said:
They may be denying it because it is not needed. None of these codes look like they bundle. Each excision should be coded separately, and they only need a modifier if you bill the same cpt more than once.
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Thank you. When you said that I was like, you know this! LOL Today has been a day, but thank you very much!!
 
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