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Medicare Denial

Annette Posted Wed 29th of June, 2016 10:20:36 AM
Hi, We billed 99213 25 with 20552 59 and Medicare rejected the 20552 for need for this level of service. Any suggestions? Thanks! Annette
SuperCoder Answered Thu 30th of June, 2016 07:32:47 AM
Please send some details of the case for us to assist you with this. Also, please share the reason for Medicare denial. Thank you.
Annette Posted Sat 09th of July, 2016 14:38:33 PM
Medicare's denial says that it isn't necessary for this service level. Doesn't make sense.
SuperCoder Answered Mon 11th of July, 2016 04:56:36 AM
With the little case information, I can just say that code 99213 is bundled into code 20552, therefore a modifier needs to be appended to the E/M service code.

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