Thank you in advance for your help.
Recently one of our payers started bundling all E/M codes billed with 76830. This code has the global identifier of XXX. Not even Medicare bundles these, but the payer states that the XXX means that the -25 is required.
I have spoken with several people who agree that the -25 should not be required, but I can't find this documented anywhere. (In fact, the one CCI reference that I have says that the -25 is correct, but that isn't how the majority of our payers, including Medicare, say.) Since I'm locking horns with one of our biggest payers, I'd really like to be able to provide documentation of an opinion that shows the -25 modifier isn't required with the Global XXX indicator.
Thank you so much for any leads and head up that you can give me. I really appreciate it!
Bryan Simonetti
AAPC student
OTJ coding & billing since 1993
Recently one of our payers started bundling all E/M codes billed with 76830. This code has the global identifier of XXX. Not even Medicare bundles these, but the payer states that the XXX means that the -25 is required.
I have spoken with several people who agree that the -25 should not be required, but I can't find this documented anywhere. (In fact, the one CCI reference that I have says that the -25 is correct, but that isn't how the majority of our payers, including Medicare, say.) Since I'm locking horns with one of our biggest payers, I'd really like to be able to provide documentation of an opinion that shows the -25 modifier isn't required with the Global XXX indicator.
Thank you so much for any leads and head up that you can give me. I really appreciate it!
Bryan Simonetti
AAPC student
OTJ coding & billing since 1993