NST with inpatient/outpatient stays

[sawils]

When an OB patient is either admitted to OBED or inpatient and an NST is performed we are coding it with the medical necessity codes and a -26 modifier. Some payers are denying this as global; some are reimbursing. The CCI edits for 59025 show the NST is not reimbursable for inpatient or outpatient E/M codes; however, everything I have researched shows we can bill this with the -26 modifier if there is medical necessity. Can anyone shed some light on this and whether it is, in fact, appropriate to bill the NST during in- and outpatient stays?

Thanks so much for the help!

 

[lscott]

We also bill when we see a patient at the facility and read the NST, with the -26 modifier. Most of our payers reimburse, sometimes we have to appeal with NST report; however, there are some payers who will NOT pay for the NST on the day of discharge, bundling it into the discharge service.

 

[sawils]

Thanks so much for your input - I appreciate it!