# Medicare denial - Now Medicare paid but not for



## nancy.anselmo@ccrheart.com (Apr 11, 2012)

This is what was billed:
93454-26-22
93306-26-59
99223-25-AQ
Now Medicare paid but not for the 93454 stating inappropriate place of service and I was told this service can not b done as inpatient. What am I missing. I see nothing in the CPT book or in the LCD that say it can not be done there. Is there a modifier I am missing or do I need to take off the 22? Thanks Nancy


----------



## rykin7609 (Apr 11, 2012)

*hope this helps*

Nancy,

Sometimes their reasons for a denial drive me crazy. I have learned never to totally trust their reasons. 

As for the three codes, I am wondering why 93306-26 has a modifier 59 adjacent to it? I just looked through the Edits and do not see where 93306 would need a 59. I have found that sometimes simple denials such as this make me scratch my head. I believe the modifier 59 is what your problem is.
I personally have never posted a 93306-26 with a modifier 59 along with a cath procedure and E&M. 



"This is what was billed:
93454-26-22
93306-26-59
99223-25-AQ
Now Medicare paid but not for the 93454 stating inappropriate place of service and I was told this service can not b done as inpatient. What am I missing. I see nothing in the CPT book or in the LCD that say it can not be done there. Is there a modifier I am missing or do I need to take off the 22? Thanks Nancy "


----------

