MMadrigal
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Doctor did a right index finger DIP joint ganglion Cyst removal and arthrotomy with osteophhyte removal distal phalanx.
I originally billed 26160 (727.41) and 26080 (715.14)
Private carrier denied 26080 stating services were included in 26160. When I read the Global Service data it specifically states removal of the osteophyte is not included in the 26160, so I then submitted a corrected claim for 26160 and 26989 (unlisted proc) with a copy of the Operative note and the GSD infomration.
The private carrier then paid the 26989, but they processed it as 26210, and then took back their payment for the 26160, stating it is included in the 26210.
Can any hand surgeon billers tell me the correct way to bill these two services? I did not use mod -59 as the there is only one incision, although he is removing 2 different lesions. ?? So frustrating. Mary
I originally billed 26160 (727.41) and 26080 (715.14)
Private carrier denied 26080 stating services were included in 26160. When I read the Global Service data it specifically states removal of the osteophyte is not included in the 26160, so I then submitted a corrected claim for 26160 and 26989 (unlisted proc) with a copy of the Operative note and the GSD infomration.
The private carrier then paid the 26989, but they processed it as 26210, and then took back their payment for the 26160, stating it is included in the 26210.
Can any hand surgeon billers tell me the correct way to bill these two services? I did not use mod -59 as the there is only one incision, although he is removing 2 different lesions. ?? So frustrating. Mary