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Wiki need help from the billing veterans/specialists

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ollielooya

True Blue
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901
Location
Everett, Washington
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New patient visit 99205 for Nevada Humana/Gold patient being seen by our specialist with dx. 346.11 and 728.85. Also EKG 93000 with dx 786.05. Billed out: 99205-25, 93000. Humana pd 93000 but denied the office visit stating HCPCS modifier is missing/invalid. Upon follow up was told MCR no longer allows the two to be billed with a modifier 25. Did (have) I missed something? I do remember reading back sometime ago a thread concerning whether or not this can be done with such a high level visit but this is the first time such a denial has impacted us. Enlightenment, advice and discussion welcomed, secondary to "administrative necessity (?) ---Suzanne
 
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