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E/M VISITS AND correct modifier for fine needle biopsy

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mje123:
Wanted to see if modifier 25 is correct to use for 99309 E/M code and fine needle aspiration biopsy?
 
Used 11100 HCPC code for biopsy.  Medicare denied payment for either code stating it was during "global surgery"

Any suggestions?
 
Thanks

Michele:
If both procedures were denied for within the global surgical period then it sounds like the patient had a procedure prior to this that is causing the denial.  Right?

Michele

mje123:
No, no procedure before this.  Just a regular visit at the ALF with biopsy in room.
 
Is 25 the correct modifier to use with E/M codes for basics like 11100 and 69210?

Michele:
Yes the 25 modifier is the correct one.

Michele

MBP:
does anyone bill for breast biopsy and u/s guidance? the dr i bill for bought a biopsy device and does her biopsies in the office now. when i bill for it i do 76645 for an initial U/S, then 19103 for biopsy, 76942 for U/S guidance for this biopsy and 99070 for a sterile tray.. the doctor asked me about billing 76098 and 76377 as well as a part of it. any suggestions? she ownes the equipment so i wouldnt use mod 26 but i am still not sure if those cpt apply to it or dont. 76377 would be the u/s after the bx i assume? any suggestions? thank you!

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