cbarb8891
Contributor
Hello to all,
We are an Allergy office in Massachusetts and we are thinking about doing Exhaled Nitric Oxide measurements (95012). I know that Medicare reimburses the procedure but cannot get a straight answer from other payors (Tufts,Harvard, BCBS etc) as to whether they will reimburse for the procedure.Two other Allergy offices said that payors are denying on the grounds that it is experimental.
Is anyone performing this procedure and if so are payors other than Medicare reimbursing? Also how are you billing it? The procedure is done usually on the same day after Bronchospasm Evaluation (94060). I am thinking it may need to be billed with a modifier 59 along with E&M and Modifier 25.
Thank You,
Christine Barboza, CPC
We are an Allergy office in Massachusetts and we are thinking about doing Exhaled Nitric Oxide measurements (95012). I know that Medicare reimburses the procedure but cannot get a straight answer from other payors (Tufts,Harvard, BCBS etc) as to whether they will reimburse for the procedure.Two other Allergy offices said that payors are denying on the grounds that it is experimental.
Is anyone performing this procedure and if so are payors other than Medicare reimbursing? Also how are you billing it? The procedure is done usually on the same day after Bronchospasm Evaluation (94060). I am thinking it may need to be billed with a modifier 59 along with E&M and Modifier 25.
Thank You,
Christine Barboza, CPC