# CPT 56501 included in E/m?



## jhaleycoder (Jul 25, 2011)

The CPT 56501 is bundling with 99213 even with the modifier 25.  I can't seem to understand why this would be included in the e/m.  Please help thank you


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## btadlock1 (Jul 25, 2011)

jhaleycoder said:


> The CPT 56501 is bundling with 99213 even with the modifier 25.  I can't seem to understand why this would be included in the e/m.  Please help thank you



Are you_ sure _it's bundling to the E/M? It's not an NCCI edit, and even if it were, the 25 modifier wouldn't help here. Anytime you have a bundling denial, you need to add a modifier to the code that's being bundled into the other code, so in this case, if 56501 is really bundling into your E/M, you'd need to add a 59 modifier to it to get both processed - the E/M would only need a modifier if the denial was the other way around. (I've seen a lot of confusion on that - for some reason, whenever people see a bundling denial and an E/M is involved, the first assumption is that the E/M needs to get a 25 modifier, and that's not always the case...)

Did you bill anything else that day?
What does your EOB say?


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## jhaleycoder (Jul 25, 2011)

Okay thanks so much for the info.. The eob is saying Pymt included in allow for other service. it was billed with a 99213.  I just figured why.  It has 10 day global. needs a -58.  I just started in primary care and they dont have any global tools or edits.  Iam used to working in surgical coding.  Now I need to see if the 99213 should of been billed but the pt did come in with asthma problems as well  Thanks so much


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## btadlock1 (Jul 25, 2011)

jhaleycoder said:


> Okay thanks so much for the info.. The eob is saying Pymt included in allow for other service. it was billed with a 99213.  I just figured why.  It has 10 day global. needs a -58.  I just started in primary care and they dont have any global tools or edits.  Iam used to working in surgical coding.  Now I need to see if the 99213 should of been billed but the pt did come in with asthma problems as well  Thanks so much



It was in a global period for something else? You'd only need a global modifier if it was bundling into another procedure from a previous DOS. You may want to call and verify that it processed correctly - it sounds like it might have denied in error, honestly. Good luck!


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