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E/M Bundled

  1. #1
    Default E/M Bundled
    Medical Coding Books
    When we bill OV with Diagnostic Nasal Endoscopy 31231 some payers deny the OV even if a mod 25 is used. The providers feel they definitely did an E&M which is significant and separately identifiable from the procedure done on same day.

    Is it a good idea to appeal these claims with the providers' documentations.

  2. #2
    I would if you have the documentation.
    Colleen CPC

  3. #3
    Stuart Sailfish Chapter
    Partha. if your physicians feel that they TRULY performed a distinct seperate E/M , then apeal it. are they seperate diagnosis codes
    as in seperate anatomical areas?
    Just because the MD says it, doesnt allways mean they are right. Read the Notes!!
    Candice Fenildo, CPC, CPMA, CPC-I, CPB, CENTC, CRHC, AAPC Fellow
    Director of Operations
    Ear, Nose and Throat Associates of South Florida, PA

    "Nothing is stronger than the heart of a volunteer"

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