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#36561 placement of port denied by Medicare

  1. Default #36561 placement of port denied by Medicare
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    Our surgeon performed a sigmoid colectomy on 8/03 and then referred the patient to the oncologist. The oncologist recommended treatment and the placement of a port. Our surgeon then placed a port #36561 on 08/19 and Medicare has now denied this claim saying "pre/post op care payment is included in the allowance for the procedure" being the colectomy. Should have there been a modifier placed on the procedure #36561. Can't recall this ever being denied before. Help!! Thanks.

  2. Default port denial
    yes, you need to apply a modifier 79 as the port is now for chemo administration

  3. #3
    Coeur d'Alene
    I agree I do add a mod 79 to ours which we have all the time.

  4. Default 36561
    Just out of curiosity....when the Oncologist ordered the port was there a separate E/M done for the port by another specialty before the procedure could be performed? I agree with the 79 modifier for the procedure. I would say no. BUT what if???

    If the oncologist sent the patient to a different specialty with no other global surgery involved for port evaluation-the other specialty would be the ordering physician-would this be billable E/M?

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