# Physician and Hospital billing same CPT code



## colemanrl (Mar 9, 2015)

I have had two outpatient surgery claims denied by a Medicare advantage plan as duplicate. We billed cpt code 15823 and the hospital billed the same cpt codes.  When I called the claims department, I was told that we needed to check the way we were billing for a possible modifier needed and to check CMS website.  Has anyone ever had heard of this?  Since it is two different entities/NPI's and TAX ID numbers i wouldn't think there would be a problem


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## mitchellde (Mar 9, 2015)

Yes the hospital bills the same codes, but they should be using a UB type of billing with outpatient bill type, and your provider should be using the 1500 type of billing with a 22 POS.  Check to be certain the facility did not include the provider services on the UB using the revenue code for physician.  I worked with some facility billers that thought because that revenue code was available, they wear suppose yo use it.


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## colemanrl (Mar 9, 2015)

Thank you so much!


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