Wiki Port Flush with E/M

[hdwyrick]

I have been looking for the guidelines to bill J1642 with an E/M. We have carriers that are denying J1642 stating bundled with the other services and all is billed is E/M and J1642. If the patient is in the office and sees the doctor and then has the nurse to do a port flush, what do I need to bill to get this paid. Do I bill a 25 modifier on the E/M? Do I bill 96523 with J1642 and E/M? HELP me understand..............

 

[mitchellde]

The 96523 is bundles with the OV. The prot flushh can only be billed if it is the only service performed that day. The J code should however pay but it may be the dx code that is holding it up. We have always used V58.81 for the port flush and the J code. Do not link it to the OV code in this case only to the J code.