Results 1 to 3 of 3

99 modifier???

  1. #1
    Default 99 modifier???
    Medical Coding Books
    Good Morning Coding world,

    I'm having issues with MCD payments for procedures that require multiple modifiers. I read under one state that if multiple modifiers are needed to use 99 and note the description of the modifer (ct,ny)

    Besides that, Mcd is telling me to use a unlisted procedure code for multiple procedures (IL).

    for e.g

    If a clinican performed multiple debridements a 11042 and 11043

    I would bill:

    and unlisted procedure code for 11042 (not sure what the unlisted code would be for debridements)

    I'm having so many problems with MCD. we provide services to MCD patients thru out the US. any help would be appreciated


  2. #2
    Columbia, MO
    not sure why they said to use an unlisted code. You would bill the 11403 and the 11402 - 59 if these were performed on 2 separate areas. It would help to have the debridement note to see the context of what you are referring to.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Fayetteville, NC
    In North Carolina we would have to bill that 11403 and 11402-51 because NC MCD does not recognize the modifier -59.
    They also do not recognize RT, LT, -50........I hate MCD
    If you perform say 5 I&D's on 5 different locations you have to use -51 (which I disagree with to start with as they are 5 different locations) and they automatically deny 4 of them and pay one. Then you have to send records and play the wait and argue game while they slowly pay one or two and deny the rest as duplicates. Then you re-send records.....It's a broken record. Sometimes depending on what the procedures are it can take over 6 months to get proper payment
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

Similar Threads

  1. Replies: 2
    Last Post: 09-18-2015, 01:17 PM
  2. Modifier 59 vs Modifier 91 for Laboratory
    By leahrey in forum Modifiers
    Replies: 1
    Last Post: 06-23-2015, 12:01 PM
  3. MODIFIER PT VS MODIFIER 33 Screening Colonoscopy
    By Ann Johnson in forum Modifiers
    Replies: 2
    Last Post: 07-19-2012, 07:08 AM
  4. Modifier 58 versus Modifier 78
    By Ramona03 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-04-2012, 12:10 PM
  5. Modifier 51 Versus Modifier 59
    By Sborkowski in forum Modifiers
    Replies: 3
    Last Post: 05-26-2009, 03:59 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.