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Medicare denial of 94010

Michelle Posted Tue 12th of May, 2015 10:44:27 AM

Medicare just recently started denying 94010 when billed with an office visit E/M code with a -25 modifier. What has changed? (Example: 99213-25 and 94010)

SuperCoder Answered Wed 13th of May, 2015 00:59:00 AM

Their is no such guidelines of not getting paid for 94010 when billed with appropriate E/M code. Please check with your Insurance. CCI Edits shows bundling of E/M code 99213 into 94010. Use -25 modifier, if your document support significant separately identifiable service.

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