10/03/2022

Medicare-Correct Billing for 99213 and 10060

I have a claim that we billed on office visit cpt code 99213 with modifier 25 along with CPT code 10060 twice one for TA and one for T5 on the same day. we tried with the TA and T5 modifiers and modifier 51 but Medicare does not like 51 modifier. How do I bill this claim so I can get paid?

The I&D is being billed with an inappropriate CPT code to Medicare. CPT 10060 should be billed if a single abscess is being drained on the DOS. Since the procedure is being done on two different sites, it should be billed with CPT code 10061. ICD-10 codes L02.612 & L02.611 should be linked to the CPT code. The office visit should be linked to the ingrown nail and pain diagnosis ICD-10 codes.