dianegodfrey@comcast.net
Guest
Need advise Please. Doctor did a TLIF at L3-L4 and L4-L5 on the left. Also, did a Posterolateral fusion on the left side at L3 and L4. Then he did Laminotomy at L5-S1 with foraminotomy.
I billed 22633, 22634, 22853 (2 units). I also billed 63052 and 63053 for Laminectomy during interbody fusion for the levels L3-L4 and L4-L5. I billed 63030-59 for the laminotomy. BCBS denied the 63030-59 stating inconsistent with the modifier used. I called BCBS and of course they we no help, they said to just file a corrected claim for that code. What is there to correct? L5-S1 should be paid because it is not part of the fusion thus modifier 59 added for distinct procedural service Any advise is appreciated so I can refile the claim. Thank you.
I billed 22633, 22634, 22853 (2 units). I also billed 63052 and 63053 for Laminectomy during interbody fusion for the levels L3-L4 and L4-L5. I billed 63030-59 for the laminotomy. BCBS denied the 63030-59 stating inconsistent with the modifier used. I called BCBS and of course they we no help, they said to just file a corrected claim for that code. What is there to correct? L5-S1 should be paid because it is not part of the fusion thus modifier 59 added for distinct procedural service Any advise is appreciated so I can refile the claim. Thank you.