Wiki Bc/bs & 81002

[DoDCoder4You]

Every article i've found on the following code have been about Medicare Denying the Following code.

81002 - non-automated, without microscopy.

Our Billers just had this Denied
and told it was bundled with the E&M which was 99213.

Any insite on this or anyone have this happen too also?
Thanks In advance =D

 

[bonzaibex]

We have one carrier who bundles the 81002 in with an E&M code all the time (Aetna). They came out with this policy a few years ago. Attaching a 25 modifier to the E&M is sufficient to unbundle it (which we do at Aetna's written suggestion). Every once in a while we'll have another carrier who bundles the 2 codes, but not consistently. Since it's not cost effective to file an appeal for a reimbursement of about $3, we just adjust it off.

Becky, CPC

 

[DoDCoder4You]

Thanks Becky.

I will pass along the Information !