Wiki bundling

[cgarci1@midwestern.edu]

Can anyone please tell me how to get reimbursement when billing 99396 physical with office visit 99213-25 and 69210 removal impacted cerumen. office visit was paid and impacted cerumen but phyical 99396 is bundling ??? very confused.

 

[twoerpel]

The e/m of 99396 is most likely bundling into the global of period of the 69210 as this is a minor surgery.

 

[Leenahz]

Can anyone please tell me how to get reimbursement when billing 99396 physical with office visit 99213-25 and 69210 removal impacted cerumen. office visit was paid and impacted cerumen but phyical 99396 is bundling ??? very confused.

If the 99213 is separate and unrelated to the 69210, a modifier 59 may work. The cerumen has to be removed via instrument, I believe. I'd check a CCI editing program if you can. Cigna has one I've used on many occasions. If someone has sources stating otherwise, please speak up

Lena

 

[solocoder]

Most payors, including Medicare, pay for one evaluation and management (E/M) visit in a day provided to a patient by the same physician or a member of the same group with the same specialty.
99396 and 99213 are both E/M services and cannot be billed together.