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92133/92134 being denied from Medica...

K

karihassa2011

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Location
Wadena, MN
Recently we have been getting denied for 92133/92134 when billed with 99212 or 99213. Can someone tell me if I am suposed to bill the E/M code with 25 modifier? Is anyone else having this problem with Medica?

Thanks.
 
Check diagnosis

you do not need a 25 modifier on the E/M code. make sure you don't have any modifiers on 92133-92134. Also check the LCD policy with medicare and make sure you have a diagnosis for medical necessity.

Hope this helps
 
Check your CCI edits. Some testing is bundled. I cant remember if it is leve 1 or 2 that bundles with the test.
 
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