Hi Everyone,
Please advise. Since when are x rays considered part of an evaluation and management? I have been coding for 15 years in Orthopedics and I have never had a denial for an x ray as included in the E&M code until now. Humana has denied 3 x rays that I billed. All were on the same patient, but on different dates of service. I can't help but think the 26 modifier I appended to the x rays has something to do with it, as the patient was in a SNF. However, when I called, I was told it was because I also charged for an office visit. I was told to send proof from the AMA guidelines that these two should not be bundled. I don't know where to get this information. Can anyone tell me?
Thank you,
Cindy Chalk, CPC
Please advise. Since when are x rays considered part of an evaluation and management? I have been coding for 15 years in Orthopedics and I have never had a denial for an x ray as included in the E&M code until now. Humana has denied 3 x rays that I billed. All were on the same patient, but on different dates of service. I can't help but think the 26 modifier I appended to the x rays has something to do with it, as the patient was in a SNF. However, when I called, I was told it was because I also charged for an office visit. I was told to send proof from the AMA guidelines that these two should not be bundled. I don't know where to get this information. Can anyone tell me?
Thank you,
Cindy Chalk, CPC