Denial from CMS (MN) on CPT 92611 Fluoroscopic Swallow Study for Dysphagia

Our billng department is asking my coding assistance in finding out why we are getting a denial from CMS on CPT code 92611. Here's the scenario. We have a Home Health Care patient coming to our hospital for outpatient services for the above named service. It is being performed by out Speech/Language Pathologist. The denial is stated as "Home Health consolidated billing and payment applies."

We did use a GN modifier as it wasn't done as a plan of care or therapy. In the meantime, we will be checking for place of services used on the claim and the revenue code used to see if that's an issue.

Any ideas or suggestions would be helpful.

Thank You.
Cindy

billing

If part of consolidated services you will need to bill Home Health.

Consolidated services

Includes OT/PT/Speech/skilled nursing so the home care company should have provided the service. If you did a swallow study in radiology. that can be billed to Medicare.