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96127 cpt code

Lori Posted Wed 04th of March, 2015 13:49:13 PM

Our office has started using cpt code 96127 for Vanderbilt testing . we are now having problems getting paid from Insurance Co's on this code.
Per Cigna and Bc/Bs we are told 96127 HCPCS code is invalid in professional services. ???

SuperCoder Answered Thu 05th of March, 2015 03:20:39 AM

Hi Lori,
Thank you for the query.
Kindly bill the code without any modifier. 26 and TC modifier are not applicable to this code. This is a assessment code.

Hope this information helps!

Lori Posted Thu 05th of March, 2015 15:36:44 PM

we do bill with the modifer we are asking why the insurance co's are not paying on this code?

SuperCoder Answered Tue 10th of March, 2015 10:32:21 AM

Hi Lori,
The insurance company is not paying you for this code because you cannot bill modifier 26 and TC with this code. These modifiers do not apply to this service.

Hope this helps!

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