Wiki EP with no bundle of HIS done

[LLovett]

Provider does what would normally be coded as 93620-26 but no bundle of HIS is done. How do we code this?

All of the literature we have is directing us to use 93602, 93603, 93610, 93612, and 93618 (all with 26 modifiers of course). The issue is the CCI edits are telling us that in order to bill some of these together you need a 59. How do you determine if a 59 is appropriate?

Also, if you add the money up, you make more doing the individual components than the comprehensive code which doesn't make sense and makes me nervous.

Any help or insight is greatly appreciated.

Thanks

Laura, CPC, CPMA, CEMC

 

[theresa.dix@tennova.com]

ep study

Laura,
you are correct. When less than a full package is documented you must bill individual components.

You have to add 59 modifier and even tho you say it is more money as long as you have documentation to back you up there should not be a problem.

three of the codes need 59 mod, they are
93603-59
93610-59
93612-59

the rest do not.
hope this helps!