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Billing multiple units to Medicare

  1. Lightbulb Billing multiple units to Medicare
    Medical Coding Books
    I have a patient with 13 lipomas. I billed 25075 on the first line and 25075 -59 with 12 units on the second line. First line was paid and second line was denied. Does anyone know how I should bill this? Thank you so much.

  2. #2
    Location
    Columbia, MO
    Posts
    12,846
    Default
    Quote Originally Posted by TERESA TAYLOR View Post
    I have a patient with 13 lipomas. I billed 25075 on the first line and 25075 -59 with 12 units on the second line. First line was paid and second line was denied. Does anyone know how I should bill this? Thank you so much.
    Surgical procedure do not come as a quantity driven service so the units should never exceed 1. you will need to bill 13 line items using the 59 on the second and subsequent.
    25075
    25075 59
    25075 59
    25075 59
    25075 59
    25075 59
    25075 59
    25075 59
    25075 59
    25075 59
    25075 59
    25075 59
    25075 59

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Milwaukee WI
    Posts
    4,466
    Default May still be denied
    This may still be denied - because it is highly unusual. Be sure to submit your operative notes which clearly outline the many separate incisions and multiple procedures performed.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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