Results 1 to 5 of 5

Add on codes and 59 modifier

  1. Default Add on codes and 59 modifier
    Medical Coding Books
    I know that add-on codes are mod 51 exempt but we are having problems getting them paid without a mod 59 also. Now I need some documentation as to whether the add-on codes can have mod 59 added or if they follow the modifiers that are linked to the primary code. Biggest insurances with this issue are BCBS and UHC and Aenta..
    Please let me know what you think or where I could find something in writing regarding this issue.
    ex: 63047-59/51 and 63048
    thank you

  2. #2
    Location
    Columbia, MO
    Posts
    12,531
    Default
    why do you have a 59/51 on the 63047?

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    I do apologize, it was an incomplete message.. typing in a hurry
    we are billing the 63047/63048 with 22612, 22614, 22630, 22849, 63047, 63048. Decompression is also performed during the surgery..

  4. #4
    Location
    Des Moines, IA
    Posts
    36
    Default
    I pulled up the NCCI edits in the CMS website. I see that 63047 is bundled with 22630. 63048 is not bundled with any of the codes provided. So, no modifier would be required for 63048. Hope that helps.
    Michelle Hanson, CPC

  5. #5
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by DYslas View Post
    I do apologize, it was an incomplete message.. typing in a hurry
    we are billing the 63047/63048 with 22612, 22614, 22630, 22849, 63047, 63048. Decompression is also performed during the surgery..

    63047/48 can be reported with 22630, when, in addition to removing the disk and preparing the vertebral endplate, the surgeon removes posterior osteophytes and decompresses the spinal cord or nerve roots, which requires work in excess of that normally performed when doing a PLIF.

Similar Threads

  1. Add-on codes and modifier 59
    By zaidaaquino in forum Modifiers
    Replies: 2
    Last Post: 02-24-2014, 04:42 PM
  2. modifier 59 with add-on codes??
    By LaSeille in forum Modifiers
    Replies: 1
    Last Post: 01-28-2013, 04:27 PM
  3. modifier and add-on codes
    By krssy70 in forum Modifiers
    Replies: 1
    Last Post: 12-25-2010, 10:00 PM
  4. Add-on Codes and Modifier 76
    By JC Gandy in forum Modifiers
    Replies: 1
    Last Post: 12-29-2009, 05:00 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.