Medical Billing Coding - Incidental procedure modifier, cpt, codes
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Thread Topic: Incidental procedure modifier
Topic Originator: Jessica
Post Date November 10, 2015 @ 11:01 AM
Incidental procedure modifier

November 10, 2015 @ 11:01 AM Reply  |  Email Friend   |  |Print  |  Top

Hello all! I have a question on usage of a modifier. A surgical procedure was denied, stating that it is incidental to the primary surgical procedure that was paid on the same day. Basically, they bundled the codes together. Insurance paid for 42145, but denied 42826. What modifier should I use to appeal the 42826? I'm thinking it would be a 59, but I just want to make sure before I submit the appeal. Thank you!

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