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codes 10061 and 20605

  1. Question codes 10061 and 20605
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    A pt came in and had the following procedures done, I posted them as such 10061 and 20605-59 along with office visit with -25 on it. Medicare came back and paid on all but the 10061, when the biller called medicare she was told that modifier -59 should have been put on the 10061. Can someone tell me which is the correct way to bill this? I am confussed because I was taught one way while I was in school and now medicare is telling me that is wrong. Please help.

  2. #2
    Medicare usually allows code 10061 with modifier 59 as long as it is a separate location. If it is the same area it is bundled.
    Hope this helps.

  3. Default
    But which of the procedures should be listed first. 10061 or 20605? 20605 costs less than 10061

  4. #4
    Columbia, MO
    Regardless of the charges, when dealing with a component of comprehensive edit, the modifier always goes on the procedure designated as the component.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    North Carolina
    Although 10061 has more RVU's than 20605...10061 bundles into 20605 per CCI edits..So according to edits...10061 would receive 59 IF both are performed at separate locations, same session.

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