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11402 & 12302 Modifier Usage

  1. Default 11402 & 12302 Modifier Usage
    Medical Coding Books
    We are finding that the insurance carriers are denying our claims when billed w/ both codes, 11402 & 12032. Is there a specific modifier we should bill w/? Or do we need to submit an appeal w/ notes?

  2. #2
    Jacksonville, FL
    I work for a large Insurance carrier and I just ran those 2 codes through our system and we allow them both, no modifiers. You shouldn't need a "59" since they technically aren't a separate site. (And that is a last resort modifier) I can't think of any other appropriate mods to bill for this scenario and my suggestion would be to contact your Provider Rep for the carrier that is denying the claims and ask what the edit is that is denying this combo.

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