Forum - Questions & Answers

Aug 3rd, 2015 - Baine2013

i billed a 99204 with a 17003 and ems code is denying for included

I billed a 99204 and a 17003 together and ems code is denied for including. i have searched and searched and come across ncci edits that state if a new pt ems code is billed on the same day a procedure is done then it is automatically seperatly reimbursable without a modifier. all insurances are denying this. i fight it with the ncci edits and it still is denying. am i doing something wrong or am i missing something that is in fine small print inbetween

Aug 3rd, 2015 - rphelps 615  1 

re: i billed a 99204 with a 17003 and ems code is denying for included

I don't know what you are reading but 99204 would need a 25 modifier. Also you cannot bill 17003 without having billed 17000 for the first lesion.



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