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denial due to bundling

  1. #1
    Location
    Worcester Ma #50805
    Posts
    22
    Default denial due to bundling
    Medical Coding Books
    surgeon preforms 2 procedures 28296 Hallux valgas w/wo sesamoidect and 28285 correction hammertoe 28285 has a 51 mod for mulitple procedure. claim denied because 28296 is bundled to 28285. the 28296 is done on the first metatarsal joint and the 28285 is done on the fifth digit to correct this do i just need to add a T9 mod to the 28285 to show that it's two different toes?

  2. #2
    Default
    I don't have any problems when I am billing mine, I do use the T modifiers, so I would do that and see what happens
    Stephanie Phillips, CPC-H
    sphillips@orhmi.com

  3. #3
    Location
    Columbia, MO
    Posts
    12,526
    Default
    you will need the toe modifiers on both codes. You should always use the toe modifiers on toe procedures.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Location
    Worcester Ma #50805
    Posts
    22
    Default
    Quote Originally Posted by mitchellde View Post
    you will need the toe modifiers on both codes. You should always use the toe modifiers on toe procedures.
    Thank you

  5. #5
    Location
    Worcester Ma #50805
    Posts
    22
    Default
    Quote Originally Posted by steffie1870 View Post
    I don't have any problems when I am billing mine, I do use the T modifiers, so I would do that and see what happens
    Thank you

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