EKG/Surgery with office visit

[joglesbee]

We had a patient come in with several different issues. I have filed the claim various ways with no pay on the EKG.

The claim looks like this:
99213 25
17110 59
93010
93005

The rejection reads, Submission/billing error - Separately billed tests have been bundled as they are considered components of the same procedure. Payment not allowed.

If someone could help me with this coding that would be appreciated.

 

[wvc0401]

Modifier 59 is not needed on this claim.

 

[wvc0401]

Also, why are you billing the EKG in components, instead of a global charge 93000?

 

[mitchellde]

I agree with above, no need for the 59 and the EKG should have been listed as the global code 93000, what dx codes are you using and how are you linking them.

 

[joglesbee]

I had tried it initially without the 59 and the EKG was not paid then either, I will try the global code to see if that gets it paid. The dx used was 42789 along with several others, but that is the one the EKG is based off of.

 

[Lisa Bledsoe]

For whatever crazy reason, 93000 does require modifier -59 according to CCI edits...

 

[mitchellde]

That is crazy, I would have never looked at that one I fail to see how it could be bundled with anything in that scenario but then they rarely ask my opinion when bundleing codes!