# Cpt 79005



## prabha (Sep 16, 2010)

Can we append modifier 59 with CPT 79005??


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## msncoder (Sep 16, 2010)

Why would you need to? There's not a NCCI edit in effect for this CPT......


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## prabha (Sep 16, 2010)

Sorry, I have enetered the question incorrectly...My question is, can we append modifier 26 to CPT 79005, because my provider says that we cannot seperate this procedure as proffessional and technical component..


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## msncoder (Sep 20, 2010)

Ahhh....well that makes more sense however the provider is mistaken. This CPT can be billed with a 26 or TC unless you are billing globally. The national Medicare Fee Schedule has this CPT broken down in Global allowable, Professional allowable, & Technical allowable as well which only further proves that this code is reimbursed separately.

Do you think that maybe it was denied to POS/TOS edit? Or that the other billing company, either the facility or the physician since I do not know which you are billing for, may have submitted the code without a modifier which would have made the insurance company reimburse them as a global charge and deny your claim?


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