erickalm
Contributor
Can we report a 59430 post partem with an E/M? Why or why not? Please site source of information.
Patient came in 4 weeks after vaginal delivery. Provider did complete post partem but also found a lump in breast. Ordered ultra sound for lump in breast. Now wants a 59430 with 99212 mod 25.
I was told that insurance will only pay the higher of the two if we submit both and they may deny both so it would be better to code just the 59430. I just need help with showing my provider why and giving her some sort of source of info: insurance, CMS guidelines etc.
Patient came in 4 weeks after vaginal delivery. Provider did complete post partem but also found a lump in breast. Ordered ultra sound for lump in breast. Now wants a 59430 with 99212 mod 25.
I was told that insurance will only pay the higher of the two if we submit both and they may deny both so it would be better to code just the 59430. I just need help with showing my provider why and giving her some sort of source of info: insurance, CMS guidelines etc.