l1ttle_0ne
Guru
If someone could give me their opinion on this claim it woudl be much appreciated. One of our physicians on 03/11 performed a 49654. The same day the patient started to hemmorrhage, and another physician in our practice took the patient back to the OR, and performed a 49560 (open incisional hernia repair) 49568 (placment of mesh for hernia) 49002 and a 36556. The second surgery was paid, but now they are requesting the money back for the 49560, and 49568 on the second surgery. I'm wondering if it's for the 77 modifier which is - Repeat Procedure by Another Physician or Other Qualified Health Care Professional. Which it was not the same procedure code specifically. Also because the second doctor is also under our tax ID i don't know if that would mae a difference. Any help you can give would be great! Thank you!
First surgery was
49654
Second surgery billed like this
49560 -77
49568 - 77
49002 - 59
36556
First surgery was
49654
Second surgery billed like this
49560 -77
49568 - 77
49002 - 59
36556