# Billing 76819 and 59025



## mar53tha (May 20, 2009)

I'm looking at claims from a facility that routinely bills for a BPP without an NST (76819) and then bills separately for the NST (59025), with a 59 modifier.  The services are taking place in two different areas of the hospital (radiology and the OB floor).  In the majority of the cases there are normal ultrasound findings (8/8), yet the NST is still performed.  In addition I have two different physician charges; one bills for the BPP only and another bills for the NST (both use the 26 Modifier).  There is no TC attaached to the facility claims.  My questions are:  1. Isn't this unbundling, and 2.  Shouldn't there be a medical indication for performing both tests (i.e. if either initial test is normal or reassuring why is a second procedure being performed?  3.  Shouldn't the facility claims have a TC attached?

thanks in advance for any insight you can give me on this!


----------

