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99223(25) denied

  1. Question 99223(25) denied
    Medical Coding Books
    Hello,


    99223 [25] and 28470 were performed on an inpatient. HIP medicare paid 28470 but denied 99223 [25] for a modifier issue.

    Help please!

  2. #2
    Default Denial
    Hi there,
    28470 has a global period of 90 days, so you might try changing your 25 modifier to a 57. You should also make sure it was an actual decision for surgery. I would also audit the 99223 to make sure it qualifies for this level of service. Hope this helps!

    Judy

  3. Default
    Thank you very much. After my research, i agree with modifier [57].

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