Question CPT 64451

[Rchaechajj@yahoo.com]

I work for an ASC & I have been getting denials from medicare on cpt 64415 when billing it with cpt 29827 & cpt 29826. I added modifier -59 to cpt 64415 because I thought that was the reason for the denial but obviously it wasn't & yes I am sending the op notes when ad-59 to show that it is definitely a separate procedure, but it is still denied. I have tried talking to the medicare reps but all they do is read me the denial code which says that the code is not compatible with another code or modifier. Any advice will help.

 

[kkidd91]

I work for an ASC & I have been getting denials from medicare on cpt 64415 when billing it with cpt 29827 & cpt 29826. I added modifier -59 to cpt 64415 because I thought that was the reason for the denial but obviously it wasn't & yes I am sending the op notes when ad-59 to show that it is definitely a separate procedure, but it is still denied. I have tried talking to the medicare reps but all they do is read me the denial code which says that the code is not compatible with another code or modifier. Any advice will help.

CPT 64415 hits an NCCI edit with CPT 29827 stating 0- not allowed I work at an ASC and we do not bill 64415 to Medicare. We have seen reimbursement with Workers comp using the XS modifier on 64415.