Wiki Billing Vital Capacity, Total

[lcole7465]

I have a patient that has Medicare, we billed a 99496 and 94150. According to the EOB from Medicare, it appears that another required service/procedure needs to be billed with the 94150 (insurance paid the 99496). I am having some difficulty finding out exactly what type of service/procedure would need to be billed with or before the 94150.

If anyone would have some insight on this, please let me know.

Thanks

 

[danskangel313]

Why are codes 99496 and 94150 being billed together? When/how was the decision for the need to do the test made? What DXs are you using?

For 94150, the guidelines state: "Codes 94010-94799 include laboratory procedure(s) and interpretation of test results. If a separate identifiable evaluation and management service is performed, the appropriate E/M service code including new or established patient office or other outpatient services (99201-99215), office or other outpatient consultations (99241-99245), emergency department services (99281-99285), nursing facility services (99304-99318), domiciliary, rest home, or custodial care services (99324-99337), and home services (99341-99350) may be reported in addition to 94010-94799."