07/26/2018

Correct Billing for CPT 11750

MEDICARE SECONDARY PAYER - DENYING FOR MODIFIERS - BLS PAID WITH THESE MODIFIERS CORRECTLY - WHAT IS WRONG WITH THESE MODIFIERS?

The issue with the modifiers are that they are redundant in reporting what services were performed on the patient. To report a bilateral matrixectomy, could mean you are reporting the same toe; two sides it should have been billed as:

• One unit of service, billed on two separate line items, with Modifier TA (Left Foot Great Toe) and Modifier T5 (Right Foot Great Toe)

The fact that the primary paid it is probably an oversite or computer edit was not picked up.