634sg4fs65g4fg
Guest
- Messages
- 156
- Best answers
- 0
Please help if you can, we are a cardiology group so we often have office visits and diagnostic testing in our office billed on the same day. Since CMS edits have gotten stronger we are finding that when we bill a stress test or echo in office, or doctor reads stress portion of nuclear test in the hospital Medicare is coming back saying the tests are bundled from my visits. I have some people in my billiing dept. that have never taken a coding class and just do not know the clinical side of charges. They only see what is denied and what we can do to get paid. Unfortunately I feel I am battling with them because they want to slap -59 on procedures or tests, or -25 on office or hospital visit because once we do that it goes through Navicure edits. I feel it is unfortunate that we cannot be paid but I am afraid I am processing incorrectly if I am adding these modifiers without just cause. I am a CPC coder with several years of experience and am very confused as to what is acceptable and what is not. When you call Medicare they will say in a situation of bundling: modifier is acceptable for this procedure, so I think to myself are they saying add the modifier? If anyone has information or an opinion, please help! I just feel awful arguing my case daily and would like more information to present to my coworkers. Thank you!! Gail