Billing 95920 with 95938 and 95939.

muem7m

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We are billing the 95920, which is an add-on code, with 95938 and 95939. Humana is denying the 95920 with the reason that it needs to be billed with a primary procedure code. We did bill with the primary procedure codes 95938 and 95939. Is anyone else having trouble billing these codes together?
 

mhstrauss

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We are billing the 95920, which is an add-on code, with 95938 and 95939. Humana is denying the 95920 with the reason that it needs to be billed with a primary procedure code. We did bill with the primary procedure codes 95938 and 95939. Is anyone else having trouble billing these codes together?
95938 and 95939 are not listed as approved for 95920 to be added to, per the 2012 Professional CPT book. That's probably where your problem is. 95938 and 95939 are not time-based codes, so not really sure how you would report "extensive" services instead of 95920 :confused:
 

mkmgt001

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95938 and 95939 are not listed as approved for 95920 to be added to, per the 2012 Professional CPT book. That's probably where your problem is. 95938 and 95939 are not time-based codes, so not really sure how you would report "extensive" services instead of 95920 :confused:
Per the CPT errata 2012 correction document, CPT 95920 SHOULD BE considered eligible with CPT 95938 & 95939.
See: http://www.ama-assn.org/resources/doc/cpt/cpt-corrections.pdf

(Use 95920 in conjunction with the study performed, 92585, 95822, 95860, 95861, 95867, 95868, 95870, 95900, 95904, 95925-95937, 95938, 95939)
 
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FCouch1

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Can you please tell me the effective date of the CPT errata 2012 correction allowing code 95938 to be billed with code 95920?
 

mkmgt001

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Because this is a CORRECTION to the 2012 CPT manual (versus a new or revised instruction), my guess is that the effective date would be 1/1/12.
 
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