• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki E&M and cast applicaton

Create Wiki
J

jovibon110@gmail.com

Networker
Messages
61
Location
Kalispell, MT
Best answers
0
WC is denying a NP visit where the doctor determined that patient had an avulsion fracture. We billed an E & M code 99203 with mod 25, application of cast 29075, supply code, and x-ray. We appealed it and the adjuster told them to pay it but they are still denying because it is a minor surgical procedure based on 2016 NCCI policy Manual. They say the E&M has to unrelated to the decision to perform the minor surgical procedure. If we had made a decision for surgery and billed a 57 they would have paid for it. Dr. made decision that fracture care not warranted, reviewed x-ray, ROS, exam, MDM, assessment & plan to treat with cast, scheduled patient back to follow up. Any feed back would be appreciated.
 
I have the same issue/question.........and can we bill an E&M for followup cast applications.... we have had many claims questioning and not paying the initial and the followup, for the E&M code.
 
You must log in or register to reply here.
Top