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Wiki 92504

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Thearslee

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Is there any NCD edits for the 92504, I know It can not be billed with another procedure in that area, but if the provider does an E/M and JUST the 92504 why won't the insurance cover??
 
When you look at the fee schedule for 92504 (in CODIFY) you see that the global for 92504 is xxx. NCCI in version 7.2 said that a payer can treat xxx global day procedures like minor procedures, 0 or 10 global days. So, all I can think is that your payer is doing that, therefore requiring a 25 modifier on the EM when using the xxx global day 92504.
 
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