Results 1 to 4 of 4

how to bill for breast refills on expanders

  1. Default how to bill for breast refills on expanders
    Medical Coding Books
    I have been trying to bill for the filling of the fluid for breast expanders and medicare keeps denying it. We are not the physician that did the mastectomy or put in the expanders. However we are filing them for the patient due to the distance they have to travel to get back to the surgeon. It is within the global 90 days. Medciare denied the code stating we needed a different modifier or the modifier was wrong.

    I used the E/M code and then used 11951 with a modifier 25. Does anyone know how to bill this. thanks.

  2. #2
    Location
    Coastal Coders
    Posts
    47
    Default
    Modifier 25 is used with the E/M code. I think 11951 with 54 modifier.
    Last edited by weshelman; 05-03-2011 at 02:38 PM.

  3. #3
    Default
    Quote Originally Posted by roxaneas View Post
    I have been trying to bill for the filling of the fluid for breast expanders and medicare keeps denying it. We are not the physician that did the mastectomy or put in the expanders. However we are filing them for the patient due to the distance they have to travel to get back to the surgeon. It is within the global 90 days. Medciare denied the code stating we needed a different modifier or the modifier was wrong.

    I used the E/M code and then used 11951 with a modifier 25. Does anyone know how to bill this. thanks.
    I don't think a modifier is needed in this case.
    Mickie Kummer, CPC, CPMA, CRC, CPC-I, AAPC Fellow

  4. #4
    Location
    Milwaukee WI
    Posts
    4,466
    Default Duplicate post
    This is a duplicate post. I answered the other one.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. resuture j tube and breast expanders
    By gbehrendt in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 05-21-2015, 02:52 PM
  2. breast expanders
    By samyjm13 in forum Plastic Surgery
    Replies: 1
    Last Post: 09-21-2012, 02:17 PM
  3. Removal of breast implants & insert tissue expanders
    By jbrock in forum Plastic Surgery
    Replies: 0
    Last Post: 07-20-2010, 08:54 AM
  4. Breast Tissue Expanders
    By anwalden in forum Outpatient Facilities
    Replies: 3
    Last Post: 03-18-2010, 03:21 PM
  5. Breast Tissue Expanders
    By tgutierrez in forum Outpatient Facilities
    Replies: 2
    Last Post: 06-26-2008, 11:34 AM

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?

Login

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.