08/02/2022

Excellus Denial-10061 with Modifier 78

attached are two operative report - three days apart - I have tried 79 and 78 and excellus denying both modifiers-CPT 10061

Modifier -78 is the appropriate modifier to bill for the procedure based on the documentation forwarded. If Excellus denied the claim, an appeal would need to be filed with the Blue Cross carrier. Without supporting documentation, Excellus will not pay for the subsequent procedure. The notes are required to justify the circumstances of performing this service shortly after an amputation.