Inclusive CPT® codes

I did not receive reimburstment from a Medicaid HMO on an E/R level charge. They advised that CPT® 99285 is inclusive to CPT® 94640. I'm not sure why any of the E/R level charges 99281-99285 would be inclusive to a pulmonary function service performed while pt was in the ER.
Does anyone have any info on this?

thanks

re: Inclusive CPT® codes

There are no bundling issues with these two codes. 94644 is bundled. You might send it back with a 59 on the 94640 but it should not be necessary. Maybe it's your place of service. Aren't these usually done in the office setting?

re: Inclusive CPT® codes

Thanks I thought the same thing. I have had the claim sent back for review and hope that it was just a processing error.

re: Inclusive CPT® codes

After thinking about it you probably need to put a 25 on the ER visit. When I bill them in the office I put a 25 on the OV and get paid for both.