Wiki 99214 bundling w/ 92273 and 95930??

[HEakin]

Aetna has begun randomly denying E/M 99214 whenever an ERG or VEP is billed on the same claim.
Second level appeals have come back upholding these denials. I am coding all lines properly.
Has anyone else had issues?

 

[Cheezum51]

Are you using the same diagnosis code for the OV and procedure? If so, their system may be assuming that you're trying to charge for an office visit on the same date of the test in order to give the test results to the patient. Just a thought.

Tom Cheezum, OD, CPC, COPC

 

[HEakin]

Are you using the same diagnosis code for the OV and procedure? If so, their system may be assuming that you're trying to charge for an office visit on the same date of the test in order to give the test results to the patient. Just a thought.

Tom Cheezum, OD, CPC, COPC

Thank you! I think that is the issue.