Wiki 92136-aving a bit of trouble

[JNBagley]

Hello!

We are having a bit of trouble with Medicare denying our 92136 codes. We have always billed 92136-26 and 92136-TC, as we do both the professional and technical components for this code. All of a sudden, Medicare is denying stating that they will not pay for this many services. And of course, the customer service reps cannot tell us how they need it billed.

Does anyone have any helpful hints or advice?

Thanks in advance!

 

[mitchellde]

Why have you been split billing this?

 

[JNBagley]

Because our physicians do both the technical and professional components. It is how they have always billed it out...I'm just a newer coder and am trying to figure out the issue here.

 

[mzkandyd]

You will need to pull your LCD for your region to view the frequency limits. However, the service may have been performed and billed with the same diagnosis, so you might need to send in a re determination if you can't get an answer on your own.

Because our physicians do both the technical and professional components. It is how they have always billed it out...I'm just a newer coder and am trying to figure out the issue here.

 

[vpcats]

If you're doing both interpretation and own the equipment (technical), you should bill global. Don't split with the two modifiers. I'm assuming your POS is office (11).