Wiki E/M visit and 87804 & 87807

[Armytexas73]

Hello and good afternoon, came across a note in which my provider saw a child for-The infant was brought in by mom who reports that the infant has been coughing and wheezing with yellow and green mucus along with congestion. No fever. Has been having trouble keeping milk down and has been crying a lot more during resting time. Also has trouble breathing with chest moving up and down fast.

My provider wants to bill a 99214 along w/ 87804 (twice) and 87807. I am curious is this acceptable?

 

[lgardner]

I am not sure what your question is.

are you asking about the level of service?
or if these 3 codes can be reported together?

 

[greatbiller]

If the provider tested for influenza A and influenza B, then 2 units of 87804 are allowed - check with the payer to see if they want it billed on 2 separate lines with a modifier on the second unit or if they want it billed on 1 line with 2 units.

 

[Armytexas73]

I am not sure what your question is.

are you asking about the level of service?
or if these 3 codes can be reported together?

I apologize my question is can my provider bill for all of those or would they be included in the level of the E/M service?

 

[Armytexas73]

If the provider tested for influenza A and influenza B, then 2 units of 87804 are allowed - check with the payer to see if they want it billed on 2 separate lines with a modifier on the second unit or if they want it billed on 1 line with 2 units.

Hello and according to the progress note, the provider did bill for both and the patient has a managed care plan through MO Health Net which I will have to further research.