Blue Cross denying PE and OV

[Radcoder86]

Is anyone else experiencing Blue Cross denying physicals that are billed with office visits? I'm using a mod 25 and a 59 if labs or immunizations are done, and I'm receiving denials all of the sudden for the PE.

 

[Cynthia Hughes]

Are you adding the modifier 25 to the PE code when immunization administration codes are billed? These are bundled by CCI edits so you will get denials of the PE and payment for the administration when modifier 25 is not appended.

 

[mitchellde]

What level of office visit and what the reason for the office visit with the PE

 

[camdavis]

From what I can remember blue cross when it comes to a split visit with both a physical and an office visit want both to have modifier 25 attached.

Jason Davis