07/18/2018
Correct Coding for CPT 20680 & 28192
We did a 20680 and a 28192 (mod 51 59) can't seem to get Excellus to pay this right - now they are saying the modifiers aren't right - help
The following changes should be made to the two codes in order for Excellus BC/BS to reimburse the surgery:
- CPT 28192 needs a site modifier in order to identify if the service was performed on the left or right foot
- Modifiers 51 and 59 should be removed from CPT 20680- per current CCI edits, CPT 20680 is not a component of CPT 28192 and should not be denied as bundled by Blue Cross. No modifiers are needed to substantiate payment
