CPT 98925-98929 Osteopathic Manipulation

insight

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I have been billing for Osteopath's who specialize in Osteopathic Manipulation for years now. We are having an issue lately getting insurance companies to pay on the E/M. Health has been denying the office visits and after I sent the chart notes and asking them to pay they still refused.
We append modifier 25 to the office visit however they are saying "the documentation does not include a separate E&M service "significant and separate" from the conditions from being treated by OMT. They are also stating Medicare Global Surgery rules.

HELP!
Osteopaths have fought for years about E&M and OMT on the same day. But it seems like the issue is coming up all the time now. Did something change?
 
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