Tara0513
Networker
I need some advice, hoping someone can help me with this scenario. My billing company is using an outside company to code all the charges. On our additional testing for organisms causing diarrhea, we are looking for 1. Anti-gliadin, fecal ELISA 2. Anti-TTG, fecal by ELISA 3. Bile Acids, fecal by ELISA. Now I have stated we should bill with CPT code 83520 x3. The outside billing company has been splitting the code into 3 parts using an XU modifier so on the claim they can detail each 83520. I do not believe this is the correct way, as I feel like they are overusing a modifier. They are stating the insurance is denying because they want to know what we are using 83520 so they feel it's best to bill the claim this way. I just want to know am I in the wrong to say not to bill this way as we are overusing a modifier? If the insurance is denying for reason of the code, then they should be submitting an appeal/reconsideration outlining each unit of the 83520. Would love some feedback on this.