multiple procedures

I bill for a Gastro Dr. and he had a 99232 (IP f/u) that I know I add a 25 mod to because he did 4 procedures on the same day. The 4 procedures are 43260 (ERCP), 43262 (w/sphincterotomy), 43264 (w/stone removal), and 43268 (w/stent placement). How do I bill this with 59 and 51 modifiers? Which ones do they go on. New at this. Thank you for any help.

multiple procedures

In order to do the coding for the this procedure (and future ones) you need to have access to the NCCI edits. They are available on Medicare's website, but most of us use a purchased coding program.

Enter all of the codes in the NCCI edits/data base.

43260 is a component of all of the other three, and may not be billed with any modifier.

Amongst the remaining three: no bundling issues. Bill the one with the highest RVUs (43264) first, then the other two with no modifier or modifier 51.

There are articles in Codapedia about multiple procedures, and these two modifiers.

There are many coding programs to chose from: codecorrect.com, the AMA has one, Ingenix, I think PMIC, the speciality societies. The only way to answer these questions is to sign up for one, pay and check the NCCI edits.

CMS does offer them in paper form, but they are hard to use,