jdibble
True Blue
I have a couple of questions my billing dept has due to insurance denials - if someone could help me that would be great. I'm pretty sure what the issue is, but I just would like to confirm as I'm not familiar with Newborn EM.
#1 - I have a hospitalist who billed 99464 Attendance at delivery and also 99460 Intial Care - newborn. The insurance is denying the 99464 as included in the 99460. I don't see that it was billed with -25 modifier. Would this be the reason for denial and if so, which code would get the modifier?
#2 - On another patient, the hospitalist billed 99462 subsequent normal newborn and then also billed 99468, Inital Neonatal critical care on the same dos. First they paid both charges, but now they are recouping the 99462 as incidental tp another procedure - would this also need the 25 modifier to pay - and again which code gets the modifier.
Thanks all for the assistance!
Jodi Dibble, CPC
#1 - I have a hospitalist who billed 99464 Attendance at delivery and also 99460 Intial Care - newborn. The insurance is denying the 99464 as included in the 99460. I don't see that it was billed with -25 modifier. Would this be the reason for denial and if so, which code would get the modifier?
#2 - On another patient, the hospitalist billed 99462 subsequent normal newborn and then also billed 99468, Inital Neonatal critical care on the same dos. First they paid both charges, but now they are recouping the 99462 as incidental tp another procedure - would this also need the 25 modifier to pay - and again which code gets the modifier.
Thanks all for the assistance!
Jodi Dibble, CPC
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