Wiki 11721

[JuarezD]

I work for an FQHC in California

we keep getting denials from one of our payers; when our billers bill 11721 with 1105, 11056 or 11057. Claims state that 11721 is not separately payable, that a modifier is needed and that 11055-11057 are exclusive when billed with 11721. I am so confused. which one is it? I thought 11721 didn't need a modifier only for Medicare. Any one know have any information?

thank you

 

[ellzeycoding]

They are bundled and not separately payable according go the NCCI edits if performed on the same digit.

You can bill the with a digit modifier on each if performed on separately digits and it should pay.