Wiki Billing 92557 with 92567 and E/M 99213

[kguzikowski]

Services billed to Medicare Advantage Plan UHC-as 99213-25, 92557 and 92567. Payer paid 92567 and 99213 with modifier 25 all services performed at the office.

Reason for denial of 92557-
4-PX INCONS W/ MODIF/REQD MODIF MISSNG.

Is the payer looking for modifier 59 to be attached? to the 92557?

 

[erjones147]

I didn't think that 92557 and 92567 needed a 59 between them. I too would like someone more familiar with SLP to weigh in

 

[mary.moore1@deancare.com]

I have the same denial, and I came on the forum to look for some answers - UHC Medicare and the same codes - 99213 with modifier 25 92567 was paid but 92557 denied with the same denial - 4
PX INCONS W/ MODIF/REQD MODIF MISSNG - I do not any additional modifiers. Denial dated 8/8/19. I think this must be an issue with UHC. Should not require 59. Medicare processes and pays these codes together with just the 25 modifier on the E/M. Does anyone else have a suggestion?