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knee xrays

  1. Default knee xrays
    Medical Coding Books
    We are having trouble getting 73565 paid when it is billed with 73562. This is for Medicare claims. When claims first billed they did not have a 59 mod so we rebilled with 59 and denied again as being included in with the 73565. CCI edits say it can be billed together with a modifier. Does anyone know if these two codes are payable separately? We have tried to look up the LCD and could not find. Any help would be appreciated.

  2. #2
    Location
    Fayetteville, NC
    Posts
    300
    Default
    What are the diagnoses? It may be a medical necessity issue.

  3. #3
    Default
    CSI states "when a standing view is combined with other views of the same knee, the code should be chosen based on the number of views". The way I understand it is if a 2 view knee (73560) is performed along with a standing view of both knees, you would just bill as 73562.

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