Wiki Toe Strapping code 29550 - Medicare denying as frequency

[joharley19]

Medicare denies when I bill 29550 with toe modifiers, ie: 29550-T8 and 29550-T9, each toe is strapped individually by the doctor. Medicare denies for frequency. I have looked everywhere for information on how to avoid this denial without having to appeal every time with medical records. Can anyone tell me what they do?

Thanks!

 

[dalanicks@aol.com]

when medicare denies anything for frequency, they want one line with a 50 modifier and double the fee but make sure its one unit.

 

[joharley19]

I get that - but it is not a bilateral issue. It is 2 separate toes. That is why this makes no sense as a denial. CPT does not state single or multiple toes.

 

[dalanicks@aol.com]

Then try one line x 2

 

[joharley19]

Ok - I will try that. thanks!

 

[CodingKing]

The code has an MUE of 1 so more than 1 unit or line will deny.

Since the code description says toes meaning 1 or more. It doesn't matter if he wrapped them separately. If it's one foot, it's 1 unit.

The code does have a bilateral status indicator of 1 so its eligible for modifier 50 so it sounds as if its toes on different feet it can be billed bilaterally

 

[joharley19]

Thanks - Where can I find the MUE list of codes - I knew years ago, but lost track of where to find it!

 

[CodingKing]

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html

Be aware the files are huge. So big its divided in to 3 files.