Resolved 10060 and 96372

[DeeM_54368]

Pt was seen for the first time and we billed 99203 with a 25 modifier, did an I&D, billed 10060 and billed an antibiotic injection with the medication and 96372. I saw the NCCI edit which has 10060 column 1 and 96372 column 2, the column 2 code would need the 59 modifier. BCBS paid for the OV, 10060 and medication but has denied the 96372 with 59, LT modifiers. Should the modifier go on the 10060? Or are we using the incorrect modifier?

 

[Alicia]

My Peer Leslie stated:
Yes, the injection itself will bundle into the global surgery pkg for the I&D. All procedures include basic injections, local anes, the whole bit. They don't like the injection of antibiotic with the I & D because it's standard of care.

Go look at the CPT Global Surgery pkg definition and you will see it there.