Wiki Medicare denial 95910

skinner

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Has anyone else got denied for billing 95910 for NCS with Novitas? We are getting CO-170 - Payment is denied when performed/billing by this type of provider. We are family practice but my doctor got his pf-NCS Certification. Any ideas?
 
Most of my NCS denials in the past were NCD related. If it's not a covered diagnois/symtom they will deny. I don't recall ever having to append any kind of modifier. Are you trying to bill an E/M visit with the NCS? They also discourage an E/M with the NCS because the exam is supposedly included. If you billed an E/M without the -25 modifier, that would deny.

If you give me the ICD-9 code you linked to the 95910, I can check the NCD.
 
I think it has to do with our doctor being Family Practice. Do you know if we have to send copy of certification to Medicare?
 
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