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Wiki Blue Cross denying PE and OV

Radcoder86

Networker
Messages
80
Location
Boise, ID
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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.
 
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.
 
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
 
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