11/01/2018

Proper Billing for CPT 28232 & 11042-Excellus

I billed 28232 and 11042 51 59 - can't get Excellus to pay -correctly - what's wrong with this coding

“After reviewing the information provided and our discussion, the claim should be billed as follows:

28232 – 79, T_ (Toe Modifier)

11042 – 79, 59

However, since procedure 28232 which has a 90 day global period was also billed in January on a different Toe without a modifier stating which Toe could cause a problem.  In order for the March procedures to get processed you may need to rebill a corrected claim with the T Modifier performed at that time. “