Wiki CTR with DeQuervains

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debmorrison

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Hello,

I am hoping someone can clarify this for me....

Dr did a Carpal Tunnel Release (CPT 64721) and at the same time did a 25000 (for deQuervains). The edits show that 25000 is not reportable with 64721, however, they were done through separate incisions. I submitted both procedures with a -59 modifier attached to 25000, and the insurance will not pay. They paid just the CTR.

Was I incorrect in doing so? We appealed with the op note and they still won't pay anything for the 25000 :mad:

thanks!
Debbie
 
I would appeal the denial with a paper claim and include a copy of NCCI edits showing modifer is allowed.
 
I have been successful in getting paid coding for 25000 and 64721, 59. A few times I have had to appeal and send the note, but with the separate incision shown clearly in the note, it hasn't been a problem to get paid. Good luck!
 
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