06/27/2022

Correct Billing for Bone Biopsy Percutaneously Toe-Medicare

proper coding for bone biopsy percutaneously of a toe for medicare insurance

According to the denial details and the scanned EOB attached to the inquiry, the bone biopsies were denied by Medicare for each patient because of an inappropriate modifier. When this procedure is performed, a site modifier should be reported to specify laterality- T modifiers should not be used. To have the procedure paid by Medicare, the claim with the -TA modifier should have a corrected claim submitted with a -LT modifier, and the claim with the -T5 modifier should have a corrected claim submitted with a -RT modifier.