I really need some help!
Lately I am having difficulty getting 45381 paid when coded with 45385. I have sent supporting documentation as well as "clear Connect" screen shot from Web Dennis showing this code combination is allowable. On one of my appeals it was stated to reference the CMS processing manual chapter 12 section 40.6. This section states that 51 modifier should be attached to the lesser of the two codes. I sent in a corrected claim and complied and received a denial stating bundled service. I have billed this code combination in the past and did not have a problem.
Is anyone experiencing this problem? if so, what have you done to remedy this.
Thank you in advance for your help!
Lately I am having difficulty getting 45381 paid when coded with 45385. I have sent supporting documentation as well as "clear Connect" screen shot from Web Dennis showing this code combination is allowable. On one of my appeals it was stated to reference the CMS processing manual chapter 12 section 40.6. This section states that 51 modifier should be attached to the lesser of the two codes. I sent in a corrected claim and complied and received a denial stating bundled service. I have billed this code combination in the past and did not have a problem.
Is anyone experiencing this problem? if so, what have you done to remedy this.
Thank you in advance for your help!