# 11740



## MP555 (Jan 4, 2018)

Got a denial for the code 11740 needs a modifier.I billed 99213 25 then 11740 mod 59.
Denied 11740.Can someone help me out.What modifier is used here.

Thank you


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## ellzeycoding (Jan 4, 2018)

Why did you put modifier 59 on it?  It is not needed.

Was the E/M truly separately identifiable?  11740 is a minor procedure and E/M is *included *with it.  E/M is billable if for a separately identifiable issue (unrelated to decision to perform the evacuation of subungual hematoma


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## lara1388 (Apr 1, 2020)

I have the same denial.  Modifier missing or inappropriate modifier on the 11740.  This one was billed with a preventative visit 99395 with a separate dx than the procedure code.  I billed with 59 first on the 11740. Medicare responded with the CO-4 modifier miss/inapp.. Billed with out the 59 on the 11740 and 25 on the 99395, still response was CO-04 with that combination.   Are they looking for anatomical modifiers?  When you phone Medicare, they can not tell you the modifier they are looking for, not even the group/ class of modifier.  Thanks for any help. Lara


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## lara1388 (Apr 1, 2020)

I think it is an anatomical modifier they are looking for.  I am going to add the modifier T5 for the area and resubmit. I'll let you know how that works out.


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