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hi there. my dentist performed procedure 15574 on 03/21/23 and then on 04/04/23 he made bone grafting. i submit claims to NJ Medicare on procedure 15574 i did not performed any modifiers, but on procedure 21215 i used M 52 and 79. Medicare denied code 21215 for those modifiers. my question for you, if I used correct modifiers or i need use just M52 for it.
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi Guest!
21215 - Graft, bone; mandible (includes obtaining graft)
Modifier 52 stands for "reduced services", which is used for bone grafting codes when the bone used is not obtained/harvested from the patient
Modifier 79 stands for "Unrelated procedure or service by the same physician during the postoperative period"
Based on what you're describing, modifier 79 may not be needed.
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