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Wiki E&M for ED

sdb67

Networker
Messages
26
Location
Temple, Texas
Best answers
0
:confused:I am receiving several claims back for E&M codes - ex. 99285 & 70450 billed together. The 70450 is being denied as inclusive to the 99285 (facility claim)
can someone help me understand why this is happening? :(
 
are you billing physician side pro fee? The 7 series code is for a CT. If you are billing pro fee you will only bill for the E/M ER code. The hospital bills for the CT. If your Dr. interprets the CT (Reads it,writes a report) you bill it with a 26 mod. But I doubt this....hospitals employ radiologists and physicians to interpret these types of tests.
Hope this helped!
 
Coding/Data Analyst

You need to apply 25 modifier to the E&M code, 99285 to identify that a procedure identified by a CPT code was performed.
 
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