AAPC - Back to school
Results 1 to 3 of 3

Thread: in patient consult w/ hemodialysis

  1. #1
    Join Date
    Apr 2007

    Default in patient consult w/ hemodialysis

    AAPC: Back to School
    i have a doctor that sometimes turns in charges for hosp consult and does hemodyalisis same day for diff dx for both. we are getting paid and denied when we bill out 99255 for problem dx and 90935 for ckd dx with a mod 59 on 90935. but now we are getting denials from medicare. they want us to bill out 99255 with a 25 mod. my question is do i drop the 59 mod on the hemo?
    Lisa A Smith, CPC
    Corpus Christi, TX

  2. #2
    Join Date
    Apr 2007


    You only need the modifier 25 on the E/M code. Leave the 90935 alone. I work for a nephrology practice in Syracuse, NY and we only use 25. You should get paid without any problems.

    Jennifer Sprague, CPC

  3. #3


    Yes, drop the 59 modifier since you are not doing multiple procedures and add 25 modifier to the consult. I worked Nephrology for 4 years then worked private dialysis clinic for another 4 years (facility side). I now work for a large group of surgeons but I miss Nephrology.

Similar Threads

  1. Help! Consult or New Patient?
    By surfroxy223@yahoo.com in forum E/M
    Replies: 2
    Last Post: 09-22-2015, 03:36 PM
  2. Consult or New Patient
    By j.berkshire in forum Auditing General Discussion
    Replies: 1
    Last Post: 03-15-2011, 09:19 PM
  3. Consult vs. New Patient
    By asasands in forum General Surgery
    Replies: 11
    Last Post: 11-03-2010, 01:51 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.