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Forum for Dupuytren's and Ledderhose 
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  • NJ BCBS paid with this code
    • NJ BCBS paid with this code
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     1
    09/06/2004 23:46
    ellen

    not registered
    09/06/2004 23:46
    ellen

    not registered

    		 NJ BCBS paid with this code

    NJ BCBS paid my NA procedure under the following:

    CPT code 26040 [Fasciotomy, palmar (eg, Dupuytren's contracture; percutaneous)] is an appropriate code for needle aponevrotomy/aponeurotomy. Another code, 26045, is for the open technique.

    09/09/2004 23:36
    Sara

    not registered
    09/09/2004 23:36
    Sara

    not registered

    		 CPT Codes

    26045 is for the open treatment - it covers the palm and one finger. If an additional finger is operated on, code 26043 needs to be used in conjunction with 26045. And code 26043 will need a 51 modifier in order to be paid. The ICD-9 code (diagnosis) is 728.6.
    09/09/2004 23:43
    Yoram Kolerstein

    not registered
    09/09/2004 23:43
    Yoram Kolerstein

    not registered

    		 BCBS pay for NA

    To Ellen: I see that BCBS NJ paid for your NA. Was the procedure done in NJ?
    Thank you, Yoram.
    09/12/2004 23:55
    ellen

    not registered
    09/12/2004 23:55
    ellen

    not registered

    		 procedure done in FL

    I have a PPO contract, so even though I had the procedure in FL with Dr. Eaton, the plan paid out of network benefits for the FL NA procedure.
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    technique   benefits   aponevrotomy   contract   Another   [Fasciotomy   following   percutaneous   treatment   appropriate   Dupuytren   contracture   additional   aponeurotomy   conjunction   procedure   modifier   diagnosis   network   operated