iflyaway777
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Hi there, I have recently received a Medicare audit denial for claims dating back to 2008 asking for their overpayment back on E&M visits billed with procedures. These were billed with a modifier 25 on the E&M and paid with no issue, now they are saying they are included. I have checked notes in the CPT manuals and on the software program we use Encoderpro.com by Ingenix and on that site it states these codes can be billed together. Did I miss an new guideling from Medicare that doesnt allow these to be billed together now? Are they going to audit all physicians for all these billings do you think? I am appealing this overpayment request and asking for a redetermination on all six of these claims, but I want to clarify for future, is there a way to know. Thanks!