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Wiki 11721

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J

JuarezD

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Concord, CA
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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
 
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.
 
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