Wiki E/M billed with a Xray Denials

[TLC]

Hello,
Is anyone else getting denials from all insurance types for a patient having a Xray along with a E/M visit? Example after a injury to check for broken bone We started adding mod 25 to the E/M. Is there any other advice anybody can give. Sometimes pays with the mod 25 and sometimes it does not.


Thank you,
Terry

 

[TThivierge]

Hi Terry
Once put dx linked with Eva Mgnt code, and modifier 25 then xray. Is the xray related to where injury is? Also on external accidents the payer wants date of injury, how did it happen (fall car accident tripped on sidewalk Etc) and location see Y92 dx blocks. We do separate claims sometimes. On xray claim need referring doc, radiologist & attending doc plus result of xray on those claims. Add NPI for radiologist
I hope helped you.
Lady T

 

[TLC]

Hi Terry
Once put dx linked with Eva Mgnt code, and modifier 25 then xray. Is the xray related to where injury is? Also on external accidents the payer wants date of injury, how did it happen (fall car accident tripped on sidewalk Etc) and location see Y92 dx blocks. We do separate claims sometimes. On xray claim need referring doc, radiologist & attending doc plus result of xray on those claims. Add NPI for radiologist
I hope helped you.
Lady T

Thank you for your help!