Kelly Posted Mon 01st of February, 2016 17:00:41 PM
Our provider gave us two codes to bill for the same date of service on a patient 23605 and 20690. We billed the codes as 23605 and 20690-51. The 20690 was denied by Medicare saying "Not covered when performed during the same session as a previous service" and "Payment adjusted:svce/proc requires qualifying svce/proc received."
Should we be using a different modifier? Can these codes be billed together under certain circumstances?
SuperCoder Answered Tue 02nd of February, 2016 03:37:17 AM
CPT code 20690 bundles into CPT code 23605, but a modifier is allowed to override this relationship.