# Facility charge for E&M and procedure



## 01051184 (Oct 6, 2011)

I have a WC insurance that is denying 99283 because it was billed with  procedure code 12001 on facility billing and it was billed on a UB. 
I'm not that familiar with facility billing and was wondering if there is a good argument to get the insurance to pay the E&M level? I was this was a usual practice when a procedure was also done. Any advise would be greatly appreciated.
Thanks in advance.


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## GaPeach77 (Oct 6, 2011)

It appears that maybe you should review the place of service code and make sure the claim was submitted as outpatient and not UB.


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## mitchellde (Oct 6, 2011)

facility outpatient claims are billed on a UB-04 but you still need the 25 modifier on the ER E&M with a procedure or they will not pay for both, be sure the rev code is 450 for both.  Assuming this is a facility claim you are talking about.


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