Wiki 22 Modifier??

[S.Kristin3@gmail.com]

One of our surgeons performed an open medial collateral ligament repair(27405) and an open lateral collateral ligament repair(27405). We want him to get paid for both procedures. Should I add a 22 modifier to the second procedure? Please help. Thank you.

 

[Orthocoderpgu]

Code 27405 has an MUE of two, meaning that it's allowed once per knee. Check your insurance. If they are Medicare or any payer that follows Medicare guidelines, you would need to bill 27405-22. If the payer does not strictly follow Medicare, you could try and bill for both. IF you do I would add a -59 to the 2nd procedure since these would be done through separate incisions.