two surgeries within 2 weeks apart

trose45116

Expert
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cincinnati
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a patient had a medial meniscectomy and a medial femoral chrondroplasty done on 9/3/15 and then the patient came back on 9/17/15 and had a resurfacing of the medial femoral condyle performed.

my question is can the surgery on 9/17 be billed out or is it bundled in with the 9/3/15 surgery since it was on the same knee at the first surgery???

9/17 was billed out with a modifier but the insurance paid it and now they are requesting the money back. your thoughts please
 

shecodes

Networker
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Date of service 9/17 should be billed with a modifier 58 or 78 depending on whether or not it was planned.

If this was done, an appeal is in order.
 
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