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Billing/Reimbursement

  1. #1
    Default Billing/Reimbursement
    Medical Coding Books
    Hi All,

    We have an established patient who came to see our MFM doctor. The doctor did a fetal non-stress test. He coded this as 99213 and 59025. The payer is denying the E/M as included in the non-stress test. We are having a big problem with them denying the E/M code as included in an ultrasound or non -stress test. Does anyone know of the correct rule for this. I have done non-stop research and have come up with nothing regarding this. Any help would be greatly appreciated!!!!!!

  2. Default
    Quote Originally Posted by posnj2010 View Post
    Hi All,

    We have an established patient who came to see our MFM doctor. The doctor did a fetal non-stress test. He coded this as 99213 and 59025. The payer is denying the E/M as included in the non-stress test. We are having a big problem with them denying the E/M code as included in an ultrasound or non -stress test. Does anyone know of the correct rule for this. I have done non-stop research and have come up with nothing regarding this. Any help would be greatly appreciated!!!!!!
    Are you using modifier 25 on the E&M code? If not, it needs to be used to indicate that the office visit (E&M) should be paid separately.

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