Wiki two speicalty providers same tax ID number

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574coding

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Hello
Can someone get back to me on how to bill two different specialty under same Tax ID number. I have incidents at the surgery center with when a CRNA and Pain specialty physician both provided services on the same patient on same day and one is getting denied. One is a anesthesia code and the other is a surgery code. Would adding modifier 59 help? Insurance is one of the blues... Blue Shield or Blue Cross.
Thank you
 
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Also, verify which TAXONOMY is being used for each provider. If they are part of the same Group/Tax ID, then you might want to make sure you have a Multi-specialty Taxonomy in your billing software when its billing claims.
 
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Are you doing two separate claims, with each person's NPI and Taxonomy on their claim under the group Tax ID? What is the denial code, and what specifically does it say?
 
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The procedure was provided in a ASC, and a E/M code was not used so I would think modifier 25 is out.
Two claims with each provider listed and their NPI with the TIN. CRNA code of 01160 and provider code of 27096. CNRA was processed and paid, but MD claim is denied. This happens to many claims like this. The collector adds modifier 59 on to the procedure code, but I question this.
Denial is the procedure is bundled with another code on the same date. As a coder, I want to make sure that we are doing it the correct way.
I am checking with the credential department to see what type of TIN we have.
This has been happening with Blue Cross, Blue Shield and ChampVA.
Thanks for any and all recommendations!
 
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The 59 modifier is when one person performs two separate procedures, so that doesn't apply here. Since the 27096 requires imaging guidance, I'm wondering if the radiologist is billing the code, and the doctor's work is getting caught up in that. If you're not using imaging, then the correct code is 20552.
 
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