AAPC - Back to school
Results 1 to 3 of 3

Thread: Ulcer coding

  1. #1
    Join Date
    Apr 2007
    Las Vegas, NV

    Default Ulcer coding

    AAPC: Back to School
    I have the following billed to Medicare:
    15931. 51

    Medicare has paid the 15936 and denied the 15931.51 as not having a qualifying procedure billed together....WHAT am I missing here?



  2. #2
    Join Date
    Apr 2007
    Manhattan, NY


    Good question.... The two CPTs are considered to be bundled, but your use of modifier 51 is allowed.... Seems you are going to have to appeal this one. If you speak to them, maybe they will tell you what the REAL denial reason is, or at least explain the one given!
    Last edited by hewitt; 12-01-2011 at 07:35 AM. Reason: spelling

  3. #3
    Join Date
    Apr 2007
    Milwaukee WI

    Default Same ulcer?

    You cannot excise the same ulcer twice in one operative session. If these were TWO ulcers, then the modifier you need is -59.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. Replies: 1
    Last Post: 11-02-2015, 12:37 PM
  2. ICD 10 ulcer coding
    By wright3709@yahoo.com in forum Podiatry
    Replies: 1
    Last Post: 10-07-2015, 04:26 AM
  3. ICD 10 Ulcer coding
    By wright3709@yahoo.com in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 10-06-2015, 09:11 AM
  4. Pressure ulcer & diabetic ulcer
    By dvanhaneghan in forum Diagnosis Coding
    Replies: 0
    Last Post: 07-18-2012, 09:29 AM
  5. ulcer debridement coding
    By CBC in forum Podiatry
    Replies: 3
    Last Post: 12-07-2011, 11:39 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?


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.