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billing question

  1. #1
    Default billing question
    Medical Coding Books
    We have a patient who undergone replacement of t-expander with permanent implant and capsulotomy. The t-expander was removed from previous incision site then a superior, medial, and lateral capsulotomy was done then afterwards the permanent implant was inserted. I billed with cpt 11970 and 19370. Blue cross didnt pay for the 19370 stating that this is an aggregate or incidental to 11970. In the NCCI edits, this two codes are not component of each other. Should I use a mod 59 on 19370 even tho they are not in the edits? Can you please give me a feed back or the same situation. I really appreciate it. Thanks.

  2. #2
    I would appeal it as is.

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