Wiki Breast Biopsies

[imelecio]

Provider did 2 breast biopsies same breast separate incision.
I billed Medicare:
19103-LT x 2 units
19295 x 2 units
76942 x 2 units

Medicare denials:
claim lacks svc
missing/incomplete/invalid from date(s) of service
Date range not valid with units submitted on all lines
Should i be billing this in a different way?
Maybe :
19103-LT
19103-LT-51
19295-Lt
19295-LT-51
76942-LT
76942-LT-51

Heelllp!!

 

[sheardmd]

I have used 59 on similar procedures and have not had any problems with it.

 

[maddisen]

Cpc, cgsc

Hi imelecio, there are a couple of things that I would change for this encounter
first off 76942 has an MUE of 1 and can only be billed one per day.
19295 does not allow modifier 51 so I would code this as follows

19103-LT
19103-59,51,LT
19295-LT
19295-59,LT
76942-26 (depending on your situration) if you own the equipment no 26

Hope this helps you out!

 

[imelecio]

Thanks so much maddisen...I will give it a try.