Chanke
Guest
Please help me on correct usage of modifier -52:
The scenario is : patient has an ov, 99212, and a lesion removal 17000 and 17110.
Our rural provider based clinic, (medicare option II) appends the following modifiers:
99212 -25
17000-59
17110-52
The rationale used is that they don't want to charge a patient the same price for 1 lesion removal as for a patient who has 14 lesions removed.
They claim that in essence the service is reduced because it is not the same amount of work as if they did remove all 14 lesions. I am concerned about the legality of this. Any input would be appreciated!!
The scenario is : patient has an ov, 99212, and a lesion removal 17000 and 17110.
Our rural provider based clinic, (medicare option II) appends the following modifiers:
99212 -25
17000-59
17110-52
The rationale used is that they don't want to charge a patient the same price for 1 lesion removal as for a patient who has 14 lesions removed.
They claim that in essence the service is reduced because it is not the same amount of work as if they did remove all 14 lesions. I am concerned about the legality of this. Any input would be appreciated!!