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Cpt 79005

  1. Default Cpt 79005
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    Can we append modifier 59 with CPT 79005??
    Prabha CPC

  2. #2
    Why would you need to? There's not a NCCI edit in effect for this CPT......
    Anita W, CIRCC, RCC, CPMA, CPC

  3. Default
    Sorry, I have enetered the question incorrectly...My question is, can we append modifier 26 to CPT 79005, because my provider says that we cannot seperate this procedure as proffessional and technical component..
    Prabha CPC

  4. #4
    Ahhh....well that makes more sense however the provider is mistaken. This CPT can be billed with a 26 or TC unless you are billing globally. The national Medicare Fee Schedule has this CPT broken down in Global allowable, Professional allowable, & Technical allowable as well which only further proves that this code is reimbursed separately.

    Do you think that maybe it was denied to POS/TOS edit? Or that the other billing company, either the facility or the physician since I do not know which you are billing for, may have submitted the code without a modifier which would have made the insurance company reimburse them as a global charge and deny your claim?
    Anita W, CIRCC, RCC, CPMA, CPC

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