Wiki VASCULAR coding question for CPT 36475

[humowitz@sbcglobal.net]

Hi everyone

Im new to vascular ( i came from 20 years of ortho).

We bill a lot of ablations, CPT 36475. I was told NOT to use a modifier RT or LT when billing Medicare only.
Well, now we are getting a flood of denials from Medicare and the denial explanation on EOB is vague and just says "missing or incomplete information".. I didnt have time to wait on hold to talk to someone at Medicare. Is it ok to put an RT or LT on this code? i dont want to rebill corrected claims until i get an answer.

Thanks so m uch
Jen

 

[whatwouldyousay]

https://www.aapc.com/blog/31421-ensure-maximum-reimbursement-understand-bilateral-indicators/

 

[lgardner]

Hi everyone

Im new to vascular ( i came from 20 years of ortho).

We bill a lot of ablations, CPT 36475. I was told NOT to use a modifier RT or LT when billing Medicare only.
Well, now we are getting a flood of denials from Medicare and the denial explanation on EOB is vague and just says "missing or incomplete information".. I didnt have time to wait on hold to talk to someone at Medicare. Is it ok to put an RT or LT on this code? i dont want to rebill corrected claims until i get an answer.

Thanks so m uch
Jen

Hi Jen,
I responded to your other post.

It's a good idea to only post a question one time. It makes it easier for others trying to search for an answer.

 

[karishmarath]

Hi Jen, I do bill a lot of Vein Ablations 36475 and I do bill it out with the anatomical site modifier. I like to do that for most of the payer simply because my provider does the ablations on different sites in different sessions, this way the payer is also aware that its a different anatomical site for different visits. Hope this helps.
Thanks