Wiki Help with Hospital Care & Procedure Charges for Medicare Patient

[bcanupp]

I work for a multispecialty practice & we're trying to bill for our GI provider's services on a patient admitted to the hospital for an unrelated condition.
On the same day, our GI saw patient for subsequent hospital care (99232) and also performed a lesion removal colonoscopy (45385). These services were billed out on separate claims to Medicare. Medicare is now denying the 99232, stating that "the service/procedure requires that a qualifying service/procedure be received and covered."
I know that there is a modifier that needs to be added to the 99232 (& maybe even the 45385), but I can't remember what it is. (Per the Medicare website, all of the other services/service dates are still pending.)

Any help that y'all can provide on this would be greatly appreciated.

Thanks in Advance!

 

[mitchellde]

Why were these billed out as separate claims? It should have all been submitted on one claim, I am thinking a 25 modifier on the visit but without the notes it is hard to say.