AAPC - Back to school
Results 1 to 2 of 2

Thread: Need Modifier for separate E/M visit?

  1. #1

    Default Need Modifier for separate E/M visit?

    AAPC: Back to School
    I code for an ENT office with an Audioloigst within the office as well. I am new to the coding world so this is all still new to me. We have been coming across denials if one of the physicians see a pt as well as the audiologist. Example: Patient came in for hearing loss and ear fullness. Physician saw patient and removed cerumen (so we coded 69210 and dx code of 380.4) the audiologist saw the patient as well and did a Comprehensive Aud. (she coded as 92567 with dx code 389.16). The claim for the audiologist was paid and the physician's encounter was denied for bundling.
    What do we need to do? Or can they not bill for separate office visits? I think they can...but like I said I am a newbie!


  2. #2


    Both are bundled services. They are not allowed when performed on same day.
    Each payor has their own instructions in billing tympanometry and cerumen removal.

    It will be more specific if you provide with insurance and state details.

    Arul CPC-A
    Last edited by Arulkarthik; 04-29-2009 at 09:55 PM.

Similar Threads

  1. ASC facility billing 2 separate dr. 2 separate procedures
    By seslinger in forum Outpatient Facilities
    Replies: 1
    Last Post: 07-07-2015, 06:36 PM
  2. separate distinct procedure-which x modifier?
    By PKOHUT in forum Modifiers
    Replies: 1
    Last Post: 03-30-2015, 08:14 AM
  3. WPS and Modifier 22 - Wants separate report?
    By Kisalyn in forum Medicare Regulations
    Replies: 0
    Last Post: 04-17-2013, 11:21 AM
  4. Separate visit or global?
    By jdibble in forum E/M
    Replies: 5
    Last Post: 09-28-2010, 07:22 AM
  5. well visit with separate E/M
    By dsmith06351 in forum E/M
    Replies: 4
    Last Post: 04-09-2009, 12:43 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.