Wiki bill and paid coding error

[jijikaren]

Can any one help me with this, two procedures were done 00740 and 00810 and 00740 paid but 00810 was denied.
Manager had brought this for me to recode, it was initially coded in India, I told manager, as per anesthesia guidelines code with the higher base unit and total time for both procedure can be billed. but manager stated 00740 was discontined and after an hour to two hour,00810 was performed, but was not coded correctly with a modifier.
How do I do this, do I have to code 00740-53 and 00810 with total time? and what of the gap in time?
I told the manager we had to do a corrected claim and refund for the paid claim.
thanks in advance for any feed back

 

[aschaeve]

For the 00740 I would, . Put the 53 modifier on the procedure code (Physician or Physician and CRNA). Use the ICD 9 code for the reason why the procedure was cancelled, if you cannot find one, use the reason why the procedure was going to be done. Use code V64.1 as the second dx., Surgical or other procedure not carried out because of contraindication or V64.2 Surgical or other procedure not carried out because of patient's decision, or V64.3 Procedure not carried out for other reasons.

Then I would code 00810 with a 59 modifier.

Just use the times for each procedure. Do not combine them.

Alicia, CPC

 

[jijikaren]

thanks