jeanae1005
Contributor
Hello! I bill for a provider who's specialty is REPRODUCTIVE ENDOCRINOLOGY. When he preforms a 58974 (Embryo Transfer) we bill a 76830-59 or a 76998-59 with it as well. I have received denials from Aetna and UHC, where they are appending the -26 modifier to these procedures and then denying the claim due to our Dr. not being a radiologist or credentialed to read the US. My issue is, that he uses the ultasound to guide him during the procedure, therefore, reads it. Am I missing something? Are they correct? How can I code this to get correctly paid? He does one of them in the office, and the other at an Ambulatory facility.
Thanks!!!
Thanks!!!