Patient Information
James Rodriguez
DOB: Mar 14, 1985 · Male
(555) 123-4567
j.rodriguez@email.com
Miami, FL 33101
Insurance
Blue Cross Blue Shield FL
Member ID: XJK987654321
Group: GRP-5500
Effective: Jan 1, 2025
Medical Codes
28296Bunionectomy with osteotomy
Qty: 1
$4,200.00
28299Hallux valgus correction
Qty: 1
$3,100.00
Attachments (1)
bunion_preop_xray.pdf
Treatment Notes
Patient presented with moderate hallux valgus deformity. Bunionectomy performed with distal metatarsal osteotomy.
Activity Timeline
Encounter recorded
Jan 28, 2026 · System
Codes auto-extracted
Jan 29, 2026 · Claimly Engine
Moved to review queue
Jan 29, 2026 · System
Clean Claim Score
Consider adding modifier 59 for multiple procedures
💡 Add modifier 59 to the second procedure line to indicate that both procedures were distinct and not incidental to each other. Without it, the payer may bundle them together and reduce or deny the additional charge.
Treatment notes could include more functional limitation details
💡 Update the treatment notes to include how the condition limits the patient's daily activities — for example, difficulty walking or pain with footwear. This strengthens the medical necessity documentation if the payer reviews the claim.
Claimly Denial Prediction
Claimly Suggestions
Consider modifier 59 for procedure pair
Billing Summary
Risk Assessment
Clean claim history with BCBS