Wiki E/M Bundled

[Partha]

When we bill OV with Diagnostic Nasal Endoscopy 31231 some payers deny the OV even if a mod 25 is used. The providers feel they definitely did an E&M which is significant and separately identifiable from the procedure done on same day.

Is it a good idea to appeal these claims with the providers' documentations.

 

[CRC CPC]

I would if you have the documentation.
Colleen CPC

 

[Candice_Fenildo]

Partha. if your physicians feel that they TRULY performed a distinct seperate E/M , then apeal it. are they seperate diagnosis codes
as in seperate anatomical areas?
Just because the MD says it, doesnt allways mean they are right. Read the Notes!!