Forum - Questions & Answers

Apr 28th, 2015 - rsartho

CPT® 87999 denied as Inclusive.

Kindly advice this procedure was included or we have any modifier to get reimbursed for Office visit..

Apr 28th, 2015 -

re: CPT® 87999 denied as Inclusive.

This is an unlisted CPT® pathology code and per the CPT® guidelines anytime you use an unlisted procedure you have to send documentation along with the claim to support why you are using the unlisted procedure. Office visits billed with lab codes do not usually need modifiers on them, but because you are using the unlisted procedure code that is why it is probaly being denied. The guidelines for billing for this procedure is listed in the begining of the Pathology and Laboratory section of the CPT® manual.

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