hannxelizabeth
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Hi everyone,
We billed Medicare for a capsule endoscopy CPT 91110 with a modifier 52 since the capsule did not make it to the ileum and according to CPT guidelines we are to bill with modifier 52. Medicare denied this stating we can not use this modifier with this code. Medicare states with E/M codes modifier 52 is not allowed and it seems like they are considering this an E/M code. Has anyone ran into this issue? Medicare states we are unable to appeal and we have no idea what to do next.
Thank you!
We billed Medicare for a capsule endoscopy CPT 91110 with a modifier 52 since the capsule did not make it to the ileum and according to CPT guidelines we are to bill with modifier 52. Medicare denied this stating we can not use this modifier with this code. Medicare states with E/M codes modifier 52 is not allowed and it seems like they are considering this an E/M code. Has anyone ran into this issue? Medicare states we are unable to appeal and we have no idea what to do next.
Thank you!