I code for an urgent care facility. We seem to be getting denials when an injection code is used. The most recent one has been Tricare, but United Health Care has done something similar, which was fixed with a modifier.
We billed the following to Tricare:
99204
S9088
96372
J1030
J1040
They didn't pay anything for the E/M or S code. The rational for the E/M code was: "Medical visit included in allowance for surgical or medical treatment according to Tricare claim check".
Are they bundling codes? Do I need a modifier? Thanks for your help.
We billed the following to Tricare:
99204
S9088
96372
J1030
J1040
They didn't pay anything for the E/M or S code. The rational for the E/M code was: "Medical visit included in allowance for surgical or medical treatment according to Tricare claim check".
Are they bundling codes? Do I need a modifier? Thanks for your help.