I am working on a denied claim for a physician. Initially, the physician performed a 99472 and later in the day also performed sedation for a diagnostic LP.
The billing office billed the services on two claims as such: 1st. claim 99472-25 and 2nd claim 00635. The claim was denied for an NCCI edit; when talking to the insurance representative she said that it might be an incorrect modifier? Would anybody be able to offer an idea of a different modifier to use that can be appended to the 99472?
The billing office billed the services on two claims as such: 1st. claim 99472-25 and 2nd claim 00635. The claim was denied for an NCCI edit; when talking to the insurance representative she said that it might be an incorrect modifier? Would anybody be able to offer an idea of a different modifier to use that can be appended to the 99472?
Thank you so much for any help or advice.