Results 1 to 3 of 3

Rac denial on 22525 cpt

  1. #1
    Unhappy Rac denial on 22525 cpt
    Exam Training Packages
    my facility (hospital) just received several RAC denials for not adding a modifier to 22525.
    I know this is an add-on code and SHOULD not require a modifier.
    I'm wondering if there is anyone else out there that has had these denials for not adding a modifier.
    Every article I'm finding is stating not to add modifiers. I haven't been able to find anything
    "official" from CMS. Can anyone provide a link to CMS for this, if there is one?
    Thanks very much.

  2. #2
    Columbia, MO
    What were all the codes submitted?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    We have been forced to add modifiers to add on codes. Specifically to 99292.
    When 99291 is submitted with a 25 we must put a 25 on the second level.
    So when you submit 22524 and it's modified (which wouldn't surprise me with the code set these days) then I would expect the add on is going to require it as well.
    They shouldn't however be asking for something other than what is on the parent code.
    There is so much overlap in these codes that I expect we will see a major overhaul in them soon.

Similar Threads

  1. denial for invalid dx with CPT billed
    By lindseyb in forum Diagnosis Coding
    Replies: 6
    Last Post: 06-15-2015, 09:42 PM
  2. denial from on cpt 22830
    By daanderson43 in forum Orthopaedics
    Replies: 1
    Last Post: 09-29-2014, 12:28 PM
  3. Help with a global denial for cpt 93290
    By stephanieOC in forum Cardiology
    Replies: 2
    Last Post: 10-02-2012, 02:15 PM
  4. CPT code 43239 Denial
    By NESmith in forum Gastroenterology
    Replies: 2
    Last Post: 08-10-2012, 07:20 AM
  5. RAC audit - CPT 96401
    By DKozenieski in forum Auditing General Discussion
    Replies: 4
    Last Post: 04-09-2011, 10:53 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.

Get OurFREE2017SalarySurvey.

We'll email you a link to our 2017 Healthcare Salary Survey when it is available so you can see your earning potential.