Wiki Why isn't Medicare acknowledging urinalysis or EKGs on bill?

[melissamiller]

I work in a family practice and Medicare eobs are coming back paying the e/m code but no ekg or urinalysis tests. We've put modifier 51s and 59s on them and still nothing on the EOB. Do they not pay for them or are using the wrong modifiers?

 

[mitchellde]

if the dx shows the UA or EKG was a part of the exam in that you needed the results as a part of the visit then they will bundle it with the E&M otherwise you need the 25 modifier to state that the tests are in fact separate from the E&M.