Wiki Wellmed need unbundled modifier

[slantzer]

with wellmed billing 17000 -59,-51 with 11102 -59, co worker was told resubmit with modifier unbundled with 17000?????

 

[vanessamoldovan]

Can you please provide additional information on the denial that you are receiving and the information from WellMed stating to bill without modifier 59? Have you tried billing without modifier 59 to see what happens? Vanessa Moldovan

 

[CodingKing]

Were there other procedures? if there are only 2 then only the column 2 code should have the -59. Though it sounds like some payers are still considering 11102 to be the column 2 code. I think it may depending on the version of NCCI that is being used i think they may have flipped them:

Find-A-Code Note: The official NCCI Edits data lists 11102 as column 1 and 17000 as column 2, but we have received customer reports of denials and that 17000 should be column 1 (paid) and 11102 should be column 2 (denied without modifiers). If this affects you, please contact your Medicare Administrative Contractor (MAC) for further clarification.

 

[slantzer]

Were there other procedures? if there are only 2 then only the column 2 code should have the -59. Though it sounds like some payers are still considering 11102 to be the column 2 code. I think it may depending on the version of NCCI that is being used i think they may have flipped them:

Find-A-Code Note: The official NCCI Edits data lists 11102 as column 1 and 17000 as column 2, but we have received customer reports of denials and that 17000 should be column 1 (paid) and 11102 should be column 2 (denied without modifiers). If this affects you, please contact your Medicare Administrative Contractor (MAC) for further clarification.

visit billed
99213 -25
11102 -59
17000 -59,51
17003-59
and the girl who billed it put it in this order:
1) 17000 -59,-51
2) 17003 -59
3) 99213 -25
4) 11102-59

 

[slantzer]

Can you please provide additional information on the denial that you are receiving and the information from WellMed stating to bill without modifier 59? Have you tried billing without modifier 59 to see what happens? Vanessa Moldovan

procedure not pd separate , tests have been bundled . and no did not remove any modifiers.
99213 and 11102 were pd