Annette Posted Tue 03rd of January, 2017 09:15:35 AM
The Provider is getting rejections for 93880. The rejection says "Payment is denied when performed/billed by this type of provider." Is there anyway around that besides changing his specialty?
SuperCoder Answered Wed 04th of January, 2017 01:25:13 AM
Annette Posted Wed 04th of January, 2017 08:33:24 AM
The provider is a GP. Can it only be done by a neurologist?
SuperCoder Answered Thu 05th of January, 2017 02:27:32 AM
If the interpretation of the report has been performed by the GP, then GP can bill for the professional component (26 modifier). However, ensure, no other physician has billed for the same professional component or has billed the global code (professional as well as the technical component).
Since, this study involves evaluation of extracranial arteries, neurologist are the most likely providers who interpret the report. However, the code discription does not restrict this code to be performed by Neurologist only. The code descriptor clearly describes the service to be performed by a physician or technician.