I have a question, are we allowed to bill for cpt code 96521 (refilling and maintenance of portable pump) and cpt code 96416?
The reason why I ask is because our CCI edits indicates that cpt 96521 would be considered bundled to 96516, further research stated that even with a 59 modifier attached to cpt code 96521 that it would be denied.
Anthem reimbursed us for it while Medicare is denying the services even with the 59 modifier. I've checked to view an updated LCD and was unable to find one.
Is someone having the same issue? please advise and/or help please.
Thank you much
Margie
The reason why I ask is because our CCI edits indicates that cpt 96521 would be considered bundled to 96516, further research stated that even with a 59 modifier attached to cpt code 96521 that it would be denied.
Anthem reimbursed us for it while Medicare is denying the services even with the 59 modifier. I've checked to view an updated LCD and was unable to find one.
Is someone having the same issue? please advise and/or help please.
Thank you much
Margie
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