Wiki E & M and xrays

[xray_amy2003@yahoo.com]

We have started noticing that Medicare is denying office visits the same time an x-ray is taken. Medicare will pay for the x-ray, but not the office visit.

The denial code is "Separately billed services have been bundled as they are considered components of the same procedure. Separate payment is not allowed."

Here is one scenario:

The patient was initially seen in the office with a metatarsal fracture, in-office closed treatment. All of the f/u x-rays are being paid, but none of the f/u office visits are being paid.

I am new to coding, so any advice would be helpful!

Thank you!
Amy

 

[mitchellde]

Did you use the code for fracture treatment? If so it has a 90 day global which means the office visits are not billable during this time.

 

[xray_amy2003@yahoo.com]

Thank you! Yes it was a fracture treatment code that we initially used. Like I said, I'm new to coding, so you have been very helpful!
Amy

 

[ACADIENTE]

office visits and xrays

I have the same problems. They even deny for the very first visit. And for establish pts, they would pay for TC xrays. And pay for E/M. PC is deny as being bundled with e/m.

"Separately billed services have been bundled as thy are considered components of the same procedure. Separate payment is not allowed."

And my boss still wants me to fight for it. I asked for advice, all he said was.. "well, by law PA can't own an xray machine".

Is there any way to it?