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Bundled services

David Posted Mon 23rd of March, 2015 10:26:41 AM

We had a patient come into the office and we billed 53600. Then the patient was admitted to the hospital and another physician from our group seen the patient and billed 52214 on the same date but as inpatient for the place of service.
I know that the 53600 is normally bundled into the 52214, but because the were done and billed with different place of service, office and inpatient, can they both be billed?
We got a denial and from my understanding it is more so that when we got paid for 52214, that it would have included payment for 53600....since they are bundled and we can't not bill regardless. But I want to make sure.
Thank you

SuperCoder Answered Tue 24th of March, 2015 08:56:01 AM

You’re correct! Ideally, with correct Coding Modifier Indicator (CCMI) of “0” as we have between CPT 52214 and 53600, the codes should never be reported together by the same provider (with same TIN) for the same beneficiary on the same date of service.

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