VNG reimbursements

[karenwelsh]

When coding for VNG's (92540 and 92543x4), is anyone having difficulty getting reimbursed for all four 92543 codes? I'm finding some difficulty with this and appealing the claim does not always work.

 

[Candice_Fenildo]

Havent had any problems at all. is it a certain payer?

if it is, you might want to contact them.

 

[karenwelsh]

No, it's not any certain payer. I've tried billing all 4, 92543 codes w/out modifyers. Sometimes I get paid for all 4, sometimes only 2 or 3 -- same insurance company.

Same thing happens at times if I use 59 modifyers. UHC seems to be the worst, and I've spoken with them about this. The rep stated that all 4 are to be paid, yet I'm having to write letters of appeal after being denied a couple of times.

Modifyers, no modifyers -- doesn't matter.

 

[gabi05]

We bill to Medicare and UHC --99243 with 4 units.
Beata
New Britain, CT

 

[esncinc]

coding modifiers for AEP, VEP, SEP...

I need some help on coding these test for a neurologist.
AEP- 92585
VEP- 95930
SEP (UP) - 95925
SEP (LOW) - 95926
Would I need to use a modifer on multiple units?
Thanks,
T

 

[Allison McCoy]

You shouldn't have to use any modifiers. The practitioner is actually doing 4 tests, warm and cold in each ear. 4 units of the code should do it. I would probably just call and have them reprocessed. Maybe try speaking to someone in medical review to figure out what the problem is in their system. We bill UHC here and I haven't gotten any denials for the code.