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Last 10 Posts (In reverse order)
Guest Posted: Monday, December 3, 2018 10:46:10 PM(UTC)
 
Message was deleted by a Moderator. | Reason: Not specified
Guest Posted: Saturday, May 14, 2016 12:27:13 PM(UTC)
 
need modifier 59
courtneydsnow Posted: Monday, November 10, 2014 1:38:27 PM(UTC)
 
Hi Guest!

Great question. Based on what you described below.... "denied the 95851 because it wasn't done as a separate procedure from the office visit" - this leads me to believe the insurer may be looking for the modifier:

-25 - significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the procedure or other service

Hope this helps. Let me know if you have any further questions!
Guest Posted: Monday, November 10, 2014 9:41:46 AM(UTC)
 
I had a patient(a claims representative for BCBSNC)call regarding their claim. They(BCBSNC) denied the 95851 because it wasn't done as a separate procedure from the office visit. The patient was told we just need to add a modifier. What modifier can I add? It wasn't done as a separate visit. I would think any modifier would still be denied since it wasn't done at a separate time. Anyone have suggestions?

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