# lumber puncture with hospital visit



## kathyle (Feb 13, 2015)

My doctor performed lumber puncture on the same day with hospital visit, i billed hospital visit 99233 with 96450 modifier 59 and got denied by medicare.  Can those 2 CPT be billing together?  99233 got denied for bundle and 96450 got denied for missing/invalid/incomplete procedure.  What did i bill wrong?


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## mhstrauss (Feb 13, 2015)

kathyle said:


> My doctor performed lumber puncture on the same day with hospital visit, i billed hospital visit 99233 with 96450 modifier 59 and got denied by medicare.  Can those 2 CPT be billing together?  99233 got denied for bundle and 96450 got denied for missing/invalid/incomplete procedure.  What did i bill wrong?



First off, 96450 is for chemo admin...is that truely what was performed? If not, LP codes are 62270-62272. Just asking because your original post doesn't mention chemo.

Secondly, for the denial, 59 wouldn't be appropriate because there is an E/M and a procedure involved, as opposed to 2 different procedures, in which case 59 may be appropriate. When you are looking at an E/M with a procedure, modifier 25 is appropriate, provided that the documentation supports the 2 separate services.

HTH!


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## kathyle (Feb 13, 2015)

Yes, chemo performed.
For what you advised, 
I should had billed 99233 w/modifier 25 and 96450?
Thank you very much for your response.


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## mhstrauss (Feb 13, 2015)

kathyle said:


> Yes, chemo performed.
> For what you advised,
> I should had billed 99233 w/modifier 25 and 96450?
> Thank you very much for your response.



Yes, I agree with this.
You're welcome!


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