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Wiki ophthalmic US

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dellasanta

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Lenoir, NC
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Does 76512 have an E&M element included in it? I don't find anything in the code description that indicates that and yet my Medicaid payers continually deny this code when billed with an E&M. What am I missing?
 
This code has both technical and professional components that have been associated with it. Therefore, it wouldn't be appropriate to also bill some sort of E&M code for performing the test.

However, if the patient was seen for an E&M type service and this procedure was also done the same day, perhaps you could use a 25 modifier for the E&M code to be paid for both services.

Tom Cheezum, O.D., CPC, COPC
 
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