Wiki Billing/Reimbursement

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Hi All,

We have an established patient who came to see our MFM doctor. The doctor did a fetal non-stress test. He coded this as 99213 and 59025. The payer is denying the E/M as included in the non-stress test. We are having a big problem with them denying the E/M code as included in an ultrasound or non -stress test. Does anyone know of the correct rule for this. I have done non-stop research and have come up with nothing regarding this. Any help would be greatly appreciated!!!!!!:confused::confused::confused:
 
posnj2010 said:
Hi All,

We have an established patient who came to see our MFM doctor. The doctor did a fetal non-stress test. He coded this as 99213 and 59025. The payer is denying the E/M as included in the non-stress test. We are having a big problem with them denying the E/M code as included in an ultrasound or non -stress test. Does anyone know of the correct rule for this. I have done non-stop research and have come up with nothing regarding this. Any help would be greatly appreciated!!!!!!:confused::confused::confused:
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Are you using modifier 25 on the E&M code? If not, it needs to be used to indicate that the office visit (E&M) should be paid separately.
 
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