I work for a Cardiopulmonary Clinic, that is owned by the hospital. I was told that Insurance will not pay for a new PT visit (99204) with ECG (93000 or 93005). Is there a guideline or rule that states why? Where can I find it? Also, is it ok to code 93040 Rhythm ECG with a New PT visit? Thank you!
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heart123
Guest
I put a mod 25 with the office visit and it gets paid
ljones88
Networker
Have you been able to find an answer to your question? I'm in the same boat here. We bill the E/M with m25 and bill 93000 globally. Medicare (and Aetna) are denying 93000 for invalid POS. I've racked my brain trying to find the rationale behind this.
espressoguy
Guest
Are you billing POS 11, 19, or 22?
If POS 19 or 22 you would bill 93010 and the facility would bill 93005. Global would only be billed in POS 11.