Bundling in Cardiology - unbundled services

amym

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BCBS is bundling our echo interpretation 93306-26 with inpatient consult 99254 stating unbundled services even after we have appealed. Is this appropriate, how can they do this when no one else does?
 

agott

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We have had this same problem, according to our provider Rep BCBS is stating that the interp for the echo is included in the descission making component of the E/M code. Her advice was to do a claim editing appeal and I have been doing this with luck, but I have been placing a -25 on the E/M code and a -26-59 on the echo code and sending in the reports with my appeal form and this seems to be working for us.
 

amym

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What supporting evidence are you using to appeal or under what circumstances are you stating that they are not bundled?
 
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