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With mod 25, use a 51 or a 59?

  1. Default With mod 25, use a 51 or a 59?
    Medical Coding Books
    99214-25
    17000 destruction of premalig. lesion
    93000 electrocardiogram

    All billed out to MR, same DOS. 93000 rejected ("1000: procedure integral to major procedure per CPT guidelines and not reimbursable separatley") and now I am rebilling correctly but need help.

    Append mod. 51 or mod. 59 to 93000?

  2. Default 59
    59-DISTINCT procedural services.

  3. #3
    Location
    Greeley, Colorado
    Posts
    2,045
    Thumbs up -59
    Definitely.
    I can't for the life of me figure out why the edits bundle like this...but they do
    Lisa Bledsoe, CPC, CPMA

  4. #4
    Location
    Nashville AAPC Chapter
    Posts
    937
    Default
    What is the medical necessity for the 93000. There is an LCD for the 93000 that I always follow when I unbundle the EKG. It supports the medical necessity, otherwise the EKG is bundled into the E/M and not reported seperately.

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