Wiki where to place modifier 79

[MargaretLeicht]

The pain management physician performed RFTC lumbar 64635 a week earlier ( global period is 10 days) and the patient had a flare up in pain afterwards from a different area. He schedueld an appointment with the physician. We billed on the first line 99214, 25 and on the second line 20610, LT, 79. Our billing company, uses a system that has said that I need to review the way I coded. However, I validated the codes and they passed. Can you tell me if this coding is accurate or if not what I should change. Thank you!

 

[amyjph]

It may not matter at all when it goes to the insurance, however the "money" modifiers always go first. So, it would be modifiers such as 24, 25, 59, 79, 78, 58 etc.

 

[MargaretLeicht]

so would you leave the 79 with the procedure code, like I did, on the second line?

 

[amyjph]

I don't know if your coding is correct without seeing the documentation. However, if you are asking what order the modifiers go in, the money modifiers go first. So the 79 would go before the LT. As for coding the office visit with a 25, major joint injection with a 79 & LT, I would have to see the documentation. Your internal system may be prompting you to make sure your documentation supports a significant, separately identifiable E/M with modifier 25 and a minor procedure (20610) during the global of a separate minor procedure (64635). Also you may have to consider modifier 24 if you are reporting an E/M during the global performed on a different DOS, not just the 20610 on the same DOS.