Wiki #36561 placement of port denied by Medicare

[mrolf]

Our surgeon performed a sigmoid colectomy on 8/03 and then referred the patient to the oncologist. The oncologist recommended treatment and the placement of a port. Our surgeon then placed a port #36561 on 08/19 and Medicare has now denied this claim saying "pre/post op care payment is included in the allowance for the procedure" being the colectomy. Should have there been a modifier placed on the procedure #36561. Can't recall this ever being denied before. Help!! Thanks.

 

[ASH527]

port denial

yes, you need to apply a modifier 79 as the port is now for chemo administration

 

[RCBBuell]

I agree I do add a mod 79 to ours which we have all the time.

 

[svail]

36561

Just out of curiosity....when the Oncologist ordered the port was there a separate E/M done for the port by another specialty before the procedure could be performed? I agree with the 79 modifier for the procedure. I would say no. BUT what if???

If the oncologist sent the patient to a different specialty with no other global surgery involved for port evaluation-the other specialty would be the ordering physician-would this be billable E/M?