Forum - Questions & Answers

May 4th, 2015 - nikkie

10060 bundled with 99214

I keep getting a denial from Medicare stating that the CPT® 10060 our doctor did is bundled with their E/M 99214. However the patients main reason for the visit was to deal with a separate chronic issue and the I&D was just mentioned during the visit and they decided to do while patient was in the office. Is there a certain way to bill out the 10060 with a 99214? I tried using Mod 25 but no help. Thanks

May 4th, 2015 -

re: 10060 bundled with 99214

I assume linked to the ICD-9 for the 10060 was not linked to the 99214 and there was no dx with the 99214 that could be associated with an abscess?

May 4th, 2015 - jvasquez 1 

re: 10060 bundled with 99214

If 10060 truly is bundling with the E/M, you have correctly billed with modifier 25, however, a lot of insurances are cracking down on this scenario looking for medical notes to justify billing them together. You'll find that you will have to appeal these a lot, to show that the visit was a separate encounter from the procedure.

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