Wiki 90870 billed with 99233

[schacon]

My psychiatrist saw the patient in the hospital and on the same day did a ECT 90870. I billed code 99233 with modifier 25 but the payer denied stating not payable modifier. Can the doctor bill for 99233 and ECT 90870 on the same day, POS is 21.

 

[judyarrubla@gmail.com]

I am having the same issue, the modifier 25 would override the CCI edit but only if the E/M is significant and separately identifiable. E/M are included in the 90870, the E/M's that are being documented simply read as a follow up of the ECT so in my opinion it is not significant, the service does not go above and beyond the procedure. But the providers insist they are supposed see the patient and bill. I can't get a clear answer.