kgoldman CPC COC
Networker
I am just wondering if anyone has experienced this.....
NP comes in w/dislocated shoulder he sx does this all the time surfing. Doc reports: 99202-25, 23650, 96372x3, (j2180?)x3. I appended Modifier 57 to the E&M and the data entry took back to the doc and changed it to 25. Claim was submitted and paid.....E&M, Procedure, drugs, but not administration of injections.
I thought in order to have both E&M and Procedure with a 90 day global 57 needed to be placed. On the eob it states 93672 is a noncovered service?
I think BCBS will end up asking for a refund. Has anyone had this happen and what was the outcome of the total situation? I was shocked with the payment, granted I have not done billing in awhile.
Thanks for any feed back and was I wrong to append mod 57?
Maybe I should post this in Ortho and Modifiers.
NP comes in w/dislocated shoulder he sx does this all the time surfing. Doc reports: 99202-25, 23650, 96372x3, (j2180?)x3. I appended Modifier 57 to the E&M and the data entry took back to the doc and changed it to 25. Claim was submitted and paid.....E&M, Procedure, drugs, but not administration of injections.
I thought in order to have both E&M and Procedure with a 90 day global 57 needed to be placed. On the eob it states 93672 is a noncovered service?
I think BCBS will end up asking for a refund. Has anyone had this happen and what was the outcome of the total situation? I was shocked with the payment, granted I have not done billing in awhile.
Thanks for any feed back and was I wrong to append mod 57?
Maybe I should post this in Ortho and Modifiers.