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VNG reimbursements

  1. #1
    Default VNG reimbursements
    Medical Coding Books
    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.

  2. #2
    Stuart Sailfish Chapter
    Havent had any problems at all. is it a certain payer?

    if it is, you might want to contact them.
    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"

  3. #3
    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.

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

  5. Default 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?

  6. Default
    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.

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