Wiki Help with modifiers

[smartcoder]

Pt was seen for excision of malignant lesion (2, on same extremity) and destruction of premalignant lesion. I am not understanding why Medicare won't pay on 11602- 76. It was billed as

17000
11602-59
11602-76, 59

Please help me with correct modifiers. Thanks!

 

[FTessaBartels]

No -76

You would NOT use the -76 modifier UNLESS the procedure was repeated on the exact same lesion.

If you have three distinct lesions you would use only -59 modifier on the 2d and 3rd CPT on your claim.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[smartcoder]

Thank you!