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59025- Missing Mod Denial

  1. Default 59025- Missing Mod Denial
    Medical Coding Books
    I received a denial for "modifier missing or inconsistent w/proc" for CPT 59025. A modifier wasn't billed with this CPT and I am unable to identify which modifier needs to be added. POS is Office. Insurance is Commercial.

  2. #2
    Default
    A modifier is usually not required when the NST is done in the office. If it's done in the hospital then you'd use a 26. Is the diagnosis correct? I would call the insurance to question this.
    Anastasia, CPC, CASCC, COBGC

  3. Default
    Did you also bill an OB ultrasound code on the same DOS? If yes, you may want to check your CCI edits.

  4. #4
    Default
    agree with the above answers ... ^
    Trish McCoy, CPC

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