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Lbooth110

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we billed a 95874, 95870, 64613 and J0585.
received reimbursement for the 64613 and the j0585, however the insurance did not pay for the 95874 and 95870. I see that there are bundling issues but should we have put a -59 on the other two codes? Please help!
 
Lisa, we also bill for similar procedures and do NOT use a modifier with the 95874 as this is an add-on code. If you will read code descriptor and instructions for 95874 in your CPT book you'll see that code 95870 should not be reported, so that may be the problem. Sounds like a corrected claim is in order here.

If they still deny the 95874 you may need to appeal because this code IS allowable with the "parent" code 64613. ---Suzanne E. Byrum CPC
 
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