Wiki Surgery w/e&m

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mconnolly

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OUR SURGEON BILLED 99231-25 WITH 47562, DECISION FOR SURGERY WAS THE DAY BEFORE. MEDICARE REDUCED THE ALLOWED AMT BECAUSE THEY SAID WE DID NOT ALSO PUT A MODIFIER ON THE 47562. WE DID NOT BILL ANY OTHER PROCEDURE WITH THIS, ONLY THE 99231 WITH THE 25 MODIFIER, WHICH WE GOT PAID FOR. DOES ANYONE KNOW WHAT MODIFIER THEY ARE LOOKING FOR? I HAVE NEVER PUT A MODIFIER ON ONE PROCEDURE DONE WITH AN E&M. OF COURSE, MEDICARE WON'T TELL ME ANYTHING. TRYING TO RESEARCH BUT COULD NOT FIND ANYTHING TO SUBSTANTIATE THAT. PLEASE HELP!!
:confused:
 
Was the decision for surgery done at the 99231-25 service if yes then you used the wrong modifier. Should have used 57 instead.
 
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