Author Topic: urology coding - 99214 and 51705 together  (Read 647 times)

kschippers10

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urology coding - 99214 and 51705 together
« on: November 08, 2016, 03:17:29 PM »
Medicare is denying 51705 as included in 99214 when billed together.  I've put modifier 25 on 99215, no modifier on 51705. Is there another way to code this to pay both procedures? Thanks.

kristin

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Re: urology coding - 99214 and 51705 together
« Reply #1 on: November 08, 2016, 07:55:52 PM »
Depending on the payer, it may be that they simply will not pay for the 51705 separately, as they consider it bundled into the E/M code. Usually, the denial for something like this is reversed...they don't pay the E/M code, but pay for the other code. I would research/contact the insurance company to see what their policy is on this.

Michele

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Re: urology coding - 99214 and 51705 together
« Reply #2 on: November 09, 2016, 10:23:21 AM »
I tried to search the NCD/LCD for 51705 but I didn't find anything.  I believe that the 51705 is considered part of the E/M service so even with the 25 modifier they are not allowing it separately.  But I would call Medicare and ask them if they can point you to an NCD/LCD or other publication that would explain it.
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