Wiki Need Modifier for separate E/M visit?

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nsclark2

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I code for an ENT office with an Audioloigst within the office as well. I am new to the coding world so this is all still new to me. We have been coming across denials if one of the physicians see a pt as well as the audiologist. Example: Patient came in for hearing loss and ear fullness. Physician saw patient and removed cerumen (so we coded 69210 and dx code of 380.4) the audiologist saw the patient as well and did a Comprehensive Aud. (she coded as 92567 with dx code 389.16). The claim for the audiologist was paid and the physician's encounter was denied for bundling.
What do we need to do? Or can they not bill for separate office visits? I think they can...but like I said I am a newbie!

Thanks!!
 
Both are bundled services. They are not allowed when performed on same day.
Each payor has their own instructions in billing tympanometry and cerumen removal.

It will be more specific if you provide with insurance and state details.


Regards,
Arul CPC-A
 
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