zvankleek1
Guest
- Messages
- 19
- Best answers
- 0
I had a denial from Medicare for the following claim. Can anyone help as I need to get this resubmitted and I cannot figure out what they want?
On 9/26 the patient falls requiring an open reduction, internal fixation of her left hip, but she was already scheduled to have a hip revision on her left, so it is postponed. We bill for both the operating surgeon and an assistant surgeon on the open reduction, internal fixation. Then on 10/5 the patient is returned to the operating room and has the revision done on her right hip. Medicare pays for the original surgery on 9/26 surgery. We now bill a 27132-80-79-RT for the assistant surgeon on 10/5 and it is rejected. They are saying missing/incomplete/invalid HCPCS. I have been taught that the 80 goes first as it is a pricing modifier, then the 79 as a statistical and the RT. Does anyone know different? Please help.
Thanks,
Zoe
On 9/26 the patient falls requiring an open reduction, internal fixation of her left hip, but she was already scheduled to have a hip revision on her left, so it is postponed. We bill for both the operating surgeon and an assistant surgeon on the open reduction, internal fixation. Then on 10/5 the patient is returned to the operating room and has the revision done on her right hip. Medicare pays for the original surgery on 9/26 surgery. We now bill a 27132-80-79-RT for the assistant surgeon on 10/5 and it is rejected. They are saying missing/incomplete/invalid HCPCS. I have been taught that the 80 goes first as it is a pricing modifier, then the 79 as a statistical and the RT. Does anyone know different? Please help.
Thanks,
Zoe