Medical Billing Forum
Billing => Billing => : Pooch56 February 11, 2019, 07:52:44 PM
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I have been receiving denials and it may have something to do with bundling which I do not completely understand. I am a Podiatrist. In a nursing facility I billed 99307 (E&M)with modifier #25 with 11721 (mycotic toe nails 6-10)with modifier #Q8. I get denials of the 11721 even though the E&M code is noted as being separate from the procedure code 11721. I do include the current PCP and last date seen on the Electronic billing. I cant seem to find any answers on line. Anyone else have this same problem or know the answer to it?
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When you say the "E&M code is noted as being separate" how is it noted? I believe if it is a separate identifiable procedure it would also need the 25 modifier.
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You need to provide more information, such as dx's used, insurance company that denied, was the 11055 denied also, did you use any other modifiers besides the 25 and the Q8 on the claim? There are about 10 reasons why the 11721 could be denying, but I can't tell you why without further info.
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