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Thread: surgery claims

  1. #1
    Join Date
    Apr 2007
    Location
    KACHINA
    Posts
    26

    Default surgery claims

    I am new to surgery billing, I would appreciate if someone can check this for me:
    A patient has a surgery on her shoulder RT and LT 23700, and wrist RT 25259
    Should I bill
    23700 modifer 50, 2 units
    25259 modifer 51, 59, 1 unit
    or
    23700 modifier RT, 1 unit
    23700 modifer LT, 59 1 unit
    25259 modifier LT, 59, 1 unit
    Thanks so much!!

  2. #2
    Join Date
    Apr 2007
    Location
    Columbia, MO
    Posts
    11,441

    Default

    You are billing for the ASC?
    then either
    23700 50 1 unit
    25259 LT 1unit
    or
    23700 RT 1 unit
    23700 LT 1 unit
    25259 LT 1 unit

    The ASC does not use 51 modifier, the 50 modifier still uses only 1 unit, you do not need a 59 for the 25259 as the code descriptor already distinguishes these as distinct and separate procedures ( you would not go thru the wrist to work on the shoulder), and you would not need a 59 if you double line list the shoulder as the RT and LT make the separate distinction for you.
    Debra Mitchell MSPH, CPC-H

  3. #3
    Join Date
    Apr 2007
    Location
    KACHINA
    Posts
    26

    Thumbs up

    I am doing billing for MUA - Manipulation Under Anesthesia. I was going to use modifier RT and LR, but I read an article saying to use 50 & 50. That's why I got confused. Thanks for your help.

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