# Billing 81002 with an E&M code



## PamMasonHBA (Jan 23, 2015)

My billing staff have been routinely writing off denied UAs (81002).  The majority of the time the code is billed with an E&M code.   Should we be adding a modifier to keep the 81002 from being bundled?


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## TiffianyEdwards (Jan 23, 2015)

*mod ? 25 or QW*

What is the denial reason? Is it being bundled? if so a 25 mod would be needed on the EM code to unbundle. Also might want to check with CLIA guidelines does the 81002 need a QW ? Is it meeting medical necessity what dx code are they billing with?


Lots of reasons it could be denied  ?


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## npricercm (Jan 24, 2015)

*Billing 81002 with an E/M code*



PamMasonHBA said:


> My billing staff have been routinely writing off denied UAs (81002).  The majority of the time the code is billed with an E&M code.   Should we be adding a modifier to keep the 81002 from being bundled?



These denials can also be payor specific, I would also check the insurance payor policy.


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## codernickie (Jun 24, 2015)

I know for aetna insurance I have to apply a modifier 25 on the E&M code but all other insurances I do not have. It has to have a proper diagnosis attach to 81002.


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