Wiki Coding Help - I have a question patient has Medicare

[tholcomb]

Good afternoon all,

I have a question patient has Medicare patient was seen in office 99213 and had destruction of 6 AK lesions, 17000 1st lesion, and 17003 2-14 lesions Medicare is denying 17003 reason they give is 17000 is global to 17003 should I add modifier 79 to 17003?


Thank you,
Tracy Holcomb, CPC-A

 

[Herbie Lorona]

So they are denying 17000 but paying 17003? If you are billing them together they should not be considered global and no modifier should be needed. I would contact them and see if that is the reason they are denying it. If so that would need to be appealed.

 

[JessH2618]

I agree. 17003 is an Add on code and by definition it cannot be billed without 17000. I would definitely call Medicare and follow up with an appeal in need be.

Jessica H, CPCD

 

[drampas3418]

i have received that denial also but it all my cases the 17000 is denying against another visit previous to this one. if the patient was seen last week for a different procedure then this is why it is denying , it will need a 79 modifier. it is most likely not denying against the 17003. hope that helps