Wiki Billing 99232 to Cigna with Reading of US

[SClayborn]

We are having an issue (Professional Claims) with Cigna paying the 99232-25, but denying both the 76818-26 and 76820-26 as inclusive. I cannot find the documentation that this is not allowed and reps just say it is bundled per their policy, though they cannot tell us where to find the policy. Any help is appreciated. Thanks!

 

[iowagirl77]

Is it possible that the facility billed these charges without the TC modifier? I've had that happen and insurance denied as payment included in the global fee they paid to facility.

 

[dkb6126]

We have had the same problem with Cigna --- bundling our physician claims to the hospital claim - even though we bill with the modifier-26 on a CMS-1500 and they bill on a UB04 (which implies the -TC so it doesn't have to be on the claim).