Wiki 61635 Modifer needed

dcrider

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Loveland, CO
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We are receiving denials from Medicare for code 61635 stating that a modifier is required. We have tried modifer 59 and was denied. Help would be welcomed
 
It would be impossible to answer without more information, a procedure note and the codes you submitted on the claim including diagnosis.
 
Did you bill this as an IN PT or OUT PT? 61635 can only be billed for IN PT, but our doctors do them on OUT PT's quite often and we can't get paid for them.:(
 
We are billing as inpatient but Medicare is stating we need a modifer and of course when we call they wont release that information
 
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