Hello everyone, I am having an issue with a few of the major insurance companies and was wondering if someone could help. We are billing either initial or subsequent hospital care codes 99221-99223 or 99231-99232 along with 78452 when our physicians interpret the radiological stress test. The insurances are denying the 78452 stating that this is included in the hospital E/M codes. Shouldn't we be able to add a 25 modifier to the E/M code so the 78452 will pay? Or is this really included. The doctor is not just reviewing the results of the diagnostic studies, but he is also interpreting the report. Please help!!