Reader Question:
92960 Includes Related E/M
Published on Fri Mar 09, 2012
Question: We've been submitting 99223 for outpatient hospital services (POS 22), but Medicare rejected the claims for invalid place of service. What is the correct code? What if there is another service, such as cardioversion (92960), on the same date? Do we need to use a modifier?Codify MemberAnswer: You should code outpatient hospital visits using the appropriate office/outpatient code, depending on the documentation (such as 99201-99215, Office or other outpatient visit ...). That should match outpatient place of service (POS) 22.You may be able to report 92960 (Cardioversion, elective, electrical conversion of arrhythmia; external) for elective cardioversion with modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) on the E/M, depending on documentation.Code 92960 has global period 000 in the Medicare Physician Fee Schedule. That means payment for 92960 includes same-day pre- and post-operative E/M services [...]