Wiki Epistaxis cautery

[maebelle@gmail.com]

We have a Medicare patient that was seen in the ER and had cautery for epistaxis control. The patient left the ER and later came to our office because they started bleeding again. Our physician did cautery as well. Our claim is being denied stating that the code for epistaxis cautery can only be billed once per day per patient. The ER physician who billed the initial charge for cautery is not associated with our practice. How is that fair that our physician does not get paid for his time and work? I have billed it every which way I can think of and it still gets denied. Has anyone had a similar situation and gotten paid or does anyone have a suggestion? I've tried modifiers, 59, 76, 78, XE, and XP all at different times. I'm at the end of my rope with this one.

 

[wynonna]

Did you try Modifier 77 for "Repeat procedure by Another Physician or Other Qualified Health Care professional?"

 

[freespririt0806]

Did you try Modifier 77 for "Repeat procedure by Another Physician or Other Qualified Health Care professional?"

mod 77 states that one physician performed procedure and it was repeated by another during global,
i would try 58 modifier related procedure by same or other qualified physician