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20610 & 99239

  1. Default 20610 & 99239
    Medical Coding Books
    Our office billed 20610 for an arthrocentesis and 99239 for discharge services. Medicare only paid for the arthrocentesis. Can anyone tell me why?

  2. #2
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    Quote Originally Posted by mmclawhorn View Post
    Our office billed 20610 for an arthrocentesis and 99239 for discharge services. Medicare only paid for the arthrocentesis. Can anyone tell me why?
    An E/M on the same day as a minor procedure will be denied unless it was a distinct, separately identifiable E/M service. If it is separate, you need to append modifier 25 to the E/M service.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  3. Default
    I forgot to mention in my first post that we did attach modifier 25 to the 99239 code.

  4. #4
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    What denial reason was given? Since 20610 is normally an office procedure, that may have something to do with it - but the actual denial reason/code would help in determining why the d/c was denied. Thanks,
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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