Wiki Global Xray?

[lisa92]

Has anyone had denials from Anthem and Cigna for x-rays when there is an admission to hospital from physician office?

Scenario: Patient seen in clinic. Physician takes x-rays and patient has a fracture that needs surgical repair. Physician sends patient to hospital for treatment.
We bill H&P and surgery with hospital POS. (No E&M for office visit) We bill x-ray only for office (POS 11). Insurance is denying x-ray in office stating global. Trying to figure out how to write appeal. Or if there is even an appeal to write.

 

[Orthocoderpgu]

I have seen this before

Not long ago (year or so) BX started denying all of our E/M visits as bundled with the X-rays taken during the visit. And of course their CSR are so ignorant that they did not see a problem with this. We ended up having to appeal all of these. You would think that they would be motivated to fix this issue, but not so much. They had to go back and reprocess claims for many months that were incorrectly denied.

Good luck

 

[lisa92]

Thank you!