# Anesthesia for post-op complications



## FractalMind (Jun 10, 2009)

Hi, we often have "same day surgeries" on patients that have post-op bleed/hematomas or other compl. for  CABG's/THORACOTOMIES/KNEE REPL, ETC. we used to bill the 2nd anesthesia proc. with mod. 78 but now Mcre is denying it because this is a surgery mod., is it OK to use 76? with a post-op complication DX? or mod. 59 will work better?
note: usually anesthesia code is the same for both procedures on the same day even though it's a post-op complication, that's why we need to append a mod.

Thanks,
Erika.


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## jdrueppel (Jun 10, 2009)

Our Medicare carrier is WPS.  They have instructed us to bill the -59 modifier when anesthesia is performed more than 1x on a date of service.  If there are no NCCI issues we generally append the -59 modifier to the lesser charge amount and note "anesthesia service x2 on this date/documentation available" on the electronic claim as we do not yet have the capability to attach documentation to our electronic claims.  This generally prompts a Medicare inquiry requesting documention.  Also of note, even with this billing specification if the two separate services are submitted together, Medicare would generally pay one and the other as a duplicate or inclusive so we currently submit the unmodified charge and once that charge is paid we then submit the modified charge.  This shouldn't be necessary as this is the whole point of the modifier but it's easier to hold then to appeal, appeal, appeal.  This seems to have solved the erroneous denials we were receiving.

Julie, CPC


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## FractalMind (Jun 11, 2009)

Thanks Julie!! this solved my mistery and it's interesting to know that if you bill Mcre after the 1st charge is paid you easily get the 2nd proc. paid as well.

cheers,
Erika.


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