you are saying ......
992XX - 25
the software says .......
94760 - 59?
survey says .......
Personally, I wouldn't code what the software says ... from the coding world, as long as documentation is supported, I would go with what you are saying. BUT you said that's how the insurance wants it to be coded? If so, I would go by what the insurance says. Every insurance is different and sometimes (most of the time ) it just doesn't make sense. chances are, in your instance, the insurances claim edit software probably doesn't recognize the first line item as an E/M. and sees it more as "two procedures". Just a guess. If that's what the insurance wanted, I don't see how you would be at risk for an audit. Make sure you get that in writing from them incase it ever were to happen.
-OR- you could code it as you originally said, wait for the denial and appeal it explaining the CPT coding guidelines.... and how they are wrong?
Just my 2 cents!
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