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Wiki surgery claims

ppma

Networker
Messages
31
Location
KACHINA
Best answers
0
I am new to surgery billing, I would appreciate if someone can check this for me:
A patient has a surgery on her shoulder RT and LT 23700, and wrist RT 25259
Should I bill
23700 modifer 50, 2 units
25259 modifer 51, 59, 1 unit
or
23700 modifier RT, 1 unit
23700 modifer LT, 59 1 unit
25259 modifier LT, 59, 1 unit
Thanks so much!!
 
You are billing for the ASC?
then either
23700 50 1 unit
25259 LT 1unit
or
23700 RT 1 unit
23700 LT 1 unit
25259 LT 1 unit

The ASC does not use 51 modifier, the 50 modifier still uses only 1 unit, you do not need a 59 for the 25259 as the code descriptor already distinguishes these as distinct and separate procedures ( you would not go thru the wrist to work on the shoulder), and you would not need a 59 if you double line list the shoulder as the RT and LT make the separate distinction for you.
Debra Mitchell MSPH, CPC-H
 
I am doing billing for MUA - Manipulation Under Anesthesia. I was going to use modifier RT and LR, but I read an article saying to use 50 & 50. That's why I got confused. Thanks for your help.
 
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