Sclerotherapy and office visit on the same day

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Good morning,
We used to be able to bill Sclerotherapy CPT 36471 with office visit 99214 on the same day. We use 24 modifier with office visit since Sclerotherapy has 10 global period. But I just received rejection from commercial payer with denial explanation that my claim is inconsistent with coding protocol.
Anyone has similar experience and if so how do you code it? Thank you
 

sclement@penbayhealthcare.org

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Local Chapter Officer
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Bangor Maine
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We rarely bill for an office visit with sclerotherapy because the decision to do it was made during a previous visit. The only time we would bill an E&M and sclero for the same visit would be when the provider addresses and appropriately documents on a completely separate problem.
 
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