Wiki Denials for CPT 95004 with E&M Code

[annagracegates@yahoo.com]

I’m starting to get a lot of denials when we code CPT code 95004 (allergy skin testing) with any kind of E&M. We apply a 25 modifier but they still want to bundle it. Even with UHC when we have to send medical records, I am now getting denials that the two codes can’t be billed together. Is anyone else having this problem?

 

[SharonCollachi]

Whenever we find that an insurance company has made a policy where procedures and E&Ms won't be paid on the same day (I'm talking to YOU, Anthem Blue Cross of California) no matter what your modifier, then we don't do them on the same day. We tell the patient they have to book a separate appointment for that, and if they balk, they can take it up with their insurance company. We want to be paid for the work we do.

 

[annagracegates@yahoo.com]

Whenever we find that an insurance company has made a policy where procedures and E&Ms won't be paid on the same day (I'm talking to YOU, Anthem Blue Cross of California) no matter what your modifier, then we don't do them on the same day. We tell the patient they have to book a separate appointment for that, and if they balk, they can take it up with their insurance company. We want to be paid for the work we do.

Thank you for your help!

 

[annagracegates@yahoo.com]

Is anyone else having an issue with allergy testing getting paid with a new patient E&M? It has been happening more and more lately. Any suggestions would be appreciated!