Wiki 93010 bundled with an EM code

[yahairag2@aol.com]

Hi all,

Is anyone getting denials for 93010 when billed with an EM code (99214) for bundle? If, yes, how do you correct this? Mainly Healthfirst insurance.

I tried adding 25 modifier to EM code and still not getting paid. I know it does not get pay much, but having to write these off will not be a good luck on our monthly financial report.

 

[amyjph]

Did you look up the payer policy on ECGs when reported with an E/M?
For example, with Medicare, an ECG is not a covered benefit when used for screening purposes or as part of a routine physical examination.

When it comes to financial reports, there is a difference between writing something off that was correctly coded and should have been billed versus something that should not have been coded and billed in the first place. It is usually the difference between voiding something and writing it off in an EPM/EMR.