Post op modifier

Terrym68

Guest
Messages
10
Best answers
0
Can someone tell me if a patient comes in for a B12 shot during a post op period what modifier I should use to get the shot paid?
 

Terrym68

Guest
Messages
10
Best answers
0
The 79 modifier I used was denied by Medicare. They said that is to be used only for surgical procedures. I just spoke with Medicare again and they insist this is the wrong modifier.
 

thomas7331

True Blue
Messages
3,147
Best answers
8
Not sure who your Medicare contractor is, but the contractor in the area where I work does not accept the post-operative period modifiers on the procedure codes in the 90000-99199 range, which would include procedures such as injections and debridements. We found that removing the modifier worked to get the claim to pay correctly.
 

debgispert

Contributor
Messages
20
Best answers
0
79 Modifier

The 79 modifier I used was denied by Medicare. They said that is to be used only for surgical procedures. I just spoke with Medicare again and they insist this is the wrong modifier.
Modifier 79 is defined as: Unrelated procedure or Service by the same physician or other qualified health care professional during the postoperative period.

I've used it in situation where a person has a surgical procedure (say a cholecystectomy) and within the 90 day global has a second procedure (like an appendectomy).

The 24 modifier goes on evaluation and management codes.

What procedure was done to put the patient in the global?
 

Terrym68

Guest
Messages
10
Best answers
0
patient had an I&D cpt code 10060. He then came in the next week for an injection of b12 and they are denying the 96372 even with 79 modifier.
 
Top