Wiki coding 81003 with E&M in POS 22 for urology group

[msymanski]

We are getting denials for urinalysis 81003 with E&M 99214 in POS 22. Denied for invalid POS, treatment carried out in invalid POS & bundled. Some carriers say to report a mod 25 on the E&M. I can't find any guidance from Medicare? Any advice is appreciated.

 

[liqgold2@aol.com]

Many carriers will not pay for a urinalysis performed in an office or especially as an outpatient; since some carriers like Aetna have suggested modifier 25 on the E/M service, try this and see what happens.

 

[a_dtaylor]

Doesn't this need a modifier QW?