Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 16,925
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hello,
i am trying tp bill implant code 20249 for dx codes C76.0 and C050 - Malignant neoplasm of palate - palate removed due to cancer....i am having trouble getting it on file/processed.
can you tell me what modifiers might be used or any info on how to bill this?
thanks for any help!
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi Guest!
It may have been a typo, but the CPT code should be 21249 instead of 20249 (20249 is not a valid CPT code).
C76.0 stands for: Malignant neoplasm of head, face and neck
C05.0 stands for: Malignant neoplasm of hard palate
21249 stands for: Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)
If the neoplasm was on the the hard palate only, you do not need C76.0.
There are no standard modifiers to use on 21249.
When you say you're having trouble getting it on file/processed, what type of denial or rejection responses are you receiving? And just to be sure, are you billing for endosteal implants, or a palatal obturator?
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Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 16,925
Was thanked: 16 time(s) in 15 post(s)
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Hello! thanks for getting back to me!
yes it was a typo - i am billing 21249 for 4 implants.
ive tried billing with modifiers and it denied as "incorrect modifiers"
ive also tried billing with no modifiers and it denies as "rejected for invalid information"
i am not sure what i am missing or what i could do differently to get them processed/paid. i would appreciate any help!
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