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Pt/inr--help me!!!

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My practice has always billed a 99211 with our PT/INRs, recently they have begun to deny as bundled. Is there some new rule I don't know about? Would it be correct to append a modifier 25 to the E&M code, or should we use a modifier 59 on the lab?

We bill the 99211 b/c a blood pressure check is done.
 

mitchellde

True Blue
Messages
13,291
Location
Columbia, MO
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The bp is inclusive to the PT check and cannot be chargexd separate. When a patient come in for a blood collection encounter such as this, then the only thing billable 8s the 364 15/16 and the lab code if performed in house.
 

rryder1963

Guest
Messages
65
Location
First Hill, Seattle WA
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You might want to reference the attached document in regards to your question

See the attached document about billing out Protime visits. It also refenences the online manuals (Chapter 15) so you can find themost recent information.
This is for Medicare; if you're getting denials from a commerical insurance, their reimbursement policy might be different--check on their website for provider information or give them a ring.
Good luck~
 

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