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Thread: CTR with DeQuervains

  1. #1

    Default CTR with DeQuervains

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    Hello,

    I am hoping someone can clarify this for me....

    Dr did a Carpal Tunnel Release (CPT 64721) and at the same time did a 25000 (for deQuervains). The edits show that 25000 is not reportable with 64721, however, they were done through separate incisions. I submitted both procedures with a -59 modifier attached to 25000, and the insurance will not pay. They paid just the CTR.

    Was I incorrect in doing so? We appealed with the op note and they still won't pay anything for the 25000

    thanks!
    Debbie

  2. #2

    Default

    I would appeal the denial with a paper claim and include a copy of NCCI edits showing modifer is allowed.

  3. #3

    Default

    Thank you...I'll try that!

  4. #4
    Join Date
    Apr 2007
    Location
    Charm City - Baltimore
    Posts
    103

    Default

    I have been successful in getting paid coding for 25000 and 64721, 59. A few times I have had to appeal and send the note, but with the separate incision shown clearly in the note, it hasn't been a problem to get paid. Good luck!
    Crystal, CPC, CCS-P

  5. #5

    Default

    Yes, I agree w/ Crystal

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