Medicare Claim re 27447/20680

My dr has billed 27447 RT and 20680 RT and Medicare is denying as not covered when performed during the same session/date as previously processed service for patient. This service /precdure requires a qualifing service be received and covered. And the qualiing procedure has not been covered. What are they looking for? Or could he code better?

re: Medicare Claim re 27447/20680

If your documention supports, I would append modifier -59;if not, do not report CPT® 20680 along with CPT® 27447.

Modifier -59 is used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. This may represent a different session or patient encounter, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries)not ordinarily encountered or performed on the same day by the same physician. However, when another already established modifier is appropriate, it should be used rather than modifier 59. Only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used.