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Wiki Can we bill 11750 and 99213 together?

Jones81201

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Dallas, GA
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We are getting denials for 99213 (office visit) as inclusive in 11750 from many payers like Humana, BCBS and Wellcare. We are using L03.031 for office visit and L60.0 in nail avulsion, is there anything wrong we are doing or are there any changes in the policies because because they are constantly denying for it :(
 
We have gotten our providers to change up their documentation a bit. If they are providing a separate E&M that is unrelated to the 11750 they have an area of the note to show
  • Clear justification that the E/M service stands alone and is not just decision-making for 11750.
Also clear indication in the note that states they are here for a new issue of ingrown nail. If they came in a week prior and ingrown nail is noted and they come back the next week for the procedure the E&M is not billable
 
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