I need some help on billing nasal septal fractures (21337) and nasal bone fractures (21320). Per the CCI edits, you can put a -59 modifier on the 21320 and they will pay it when billing with the 21337, but obviously this is only if it is truly a separate procedure. My physician says this should be able to be paid separately, but I am not sure that the documentation I have been given supports this. The payer is actually Humana, not Medicare, so the CCI edits don't really have anything to do with this particular claim.
The op report states: "The Asch forceps was used to medialize the septum from the right over to the midline position and butter knife was used to carefully elevate the depressed segment on the right side, and manual manipulation was used to move the nasal dorsum from the left over to the midline position."
So after reading this, do you think the 21320 can be billed separately? Thanks in advance for any help!!
- Medical Coding
- Medical Billing
- Practice Management
- Exam Preparation
- Other Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Software / Digital
- Code Lookup (AAPC Coder)
- Virtual Coding Experience (Practicode)
- E/M Analyzer
- CPT RVU Calculator
- Health Plan Search (Provider Policies)
- Log In / Join