Agadum0109
Guest
Greetings!
My surgeon performed a ligament fixation for prolapse (57282) at the same time as a non-OB perineoplasty (56810). We have received a letter from BCBS stating that because these are designated "separate procedures" that we need to bill a -59 modifier on the perineoplasty for it to be paid. However, there are no CCI edits for this combination of codes. I don't want to just put the modifier on without questioning, since this modifier can be a red flag.
Can anyone shed some light on why BCBS might want this modifier? Is this an appropriate modifier in this case?
Thank you in advance!
Agatha O.
CPC-A
My surgeon performed a ligament fixation for prolapse (57282) at the same time as a non-OB perineoplasty (56810). We have received a letter from BCBS stating that because these are designated "separate procedures" that we need to bill a -59 modifier on the perineoplasty for it to be paid. However, there are no CCI edits for this combination of codes. I don't want to just put the modifier on without questioning, since this modifier can be a red flag.
Can anyone shed some light on why BCBS might want this modifier? Is this an appropriate modifier in this case?
Thank you in advance!
Agatha O.
CPC-A