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Wiki Closed nasal fracture with simple laceration repair question.

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msunders

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I am working appeals and we had a patient come in with a superficial layer of epidermis partially abraded away with laceration in center of abrasion, somewhat gaping and extending to mucosal surface 3cm laceration to the lip and a 1cm superficial stellate laceration to the left lateral nose. A xray was done due to nasal deformity and patient had a bilateral nasal bone fracture with some deviation of the septum, physician did set up a follow up with ENT for a consult on the nasal fracture. It was billed out as 99285-25, 12052 (lip lac reapir), 12011 (nasal lac repair), and 21310. Insurance denied laceration repairs as being part of professional care, I know the 12011 should have had a 59 modifier, but should the laceration repair have been billed with the fracture care on the same location?
 
you can bill both laceration repair and Fx care together. providers do the work they should get paid for all of it, use 59 on both laceration repairs and 25 on E&M
 
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