Patient presents to emergency room with both inflamed appendix (540.9) and umbilical hernia (553.1) and taken to OR for both laparoscopic appendectomy (44970) and umbilical hernia repair (49585). I do not have previous experience with billing both procedures for the same surgical session. Can anyone with experience indicate that insurance companies (both Medicare or private) will accept claim with both procedures and if so was modifier 59 required for 49585 entered as secondary procedure because it has lower RVU?
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