Forum - Questions & Answers

Jun 30th, 2014 - cwaggoner


I work in a family practice and we billed out two procedures that were done on the same day, same physician. Insurance is denying due to procedure is considered incidental to or a part of the primary procedure. Which tells me we need a modifier, I send a corrected claim adding modifier 59 to the second code, however still denied.

11422 DX-706.2
11200-59 DX-701.9

Would I need a modifier 51 and 59 on the 11200? or would the modifier be on the first code?

Thank you for your advice in advance.

cwaggoner, CPC

Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2023 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association