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94200 lung function test denying in POS 22

J

JDuhaime

Contributor
Messages
21
Location
Norfolk, CT
New to pulmonary coding, Looking for guidance for - Medicare is denying 94200 as not covered in POS 22. Where can I find guidelines stating that it cannot be bill in POS 22. I want to make sure before I send as a write off
 
If you're billing for the physician, you would need to add a modifier 26 in order for this to be paid in a facility place of service. Since this code has a technical and professional component, only the hospital can bill for the technical portion since they would be responsible for providing any of the equipment used. The physician may bill for the interpretation only, if performed.
 
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