Wiki Medicare Denied CPT code 92588

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I am new to ENT billing. I am getting denials from Medicare for CPT codes 92588,92504,92550, 92553, 92557, 92567. Denial states procedure code is inconsistent with modifier used or a required modifier is missing. I added modifier 51 to all after the first modifier was billed. Here is what my claim looked like 99213-25, 92557, 92588-51, 92504-51, and 92550-51. Should I leave the modifier off? Or is modifier 59 the appropriate modifier? Any help would be appreciated. Thanks
 
You should not use modifier 51 on any hearing tests, 92588, 92550, or 92557; also, you should not be billing 92550, it is inherent to 92557, comprehensive audiometry; I would be interested in why you are billing 92504? binocular microscopy, was cerumen removed? and what are you diagnosis codes ? Another concern would be the mod. 25 on the visit, if you are billing and E/M with hearing tests or say xrays, mod. 25 is not warranted, so there are a lot of questions regarding this claim.

Jennifer
CT ENT
 
Thanks for the response. I am not billing 92550 and 92557 together. I was asking because Ive gotten multiple denials for different claims for different patients. I was giving different scenarios to see if a modifier is necessary to use for multiple hearing tests. I am billing 92504 for the cerumen removal. And only billing office visit w modifier 25 if other services were rendered outside of the hearing test. My main question is should I use a modifier if multiple tests are done? Sorry for the confusion.
 
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Jennifer, CPT Code's 92557 and 92550 are NOT inherent to each other??

Why would you say that?

92557 is a Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)

and CPT 92550 is for Tympanometry and reflex threshold measurements which is 92567 & 92568 Combined

I do agree though that NONE of the Audiometric codes should have -51 modifier appended tho them
 
Does the code 92550 has to be location specific or is it ok to pay for SNF POS 32

Hello to all,

Does the code 92550 has to be location specific or is it ok to pay for SNF POS 32

Thank you
 
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