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NCV coding and purchasing studies

Julie Posted Mon 03rd of January, 2011 23:17:24 PM

I bill for a neurologist that is going to start interpreting purchased diagnostic radiology studies. I need to know if there is a modifier I need to use to show that the studies are purchased. He will be billing globally and paying the testing facilities for the studies.
I am also having to clarify for another biller, but if there is documentation somewhere I would love to have. When billing the NCVs, she is just adding a 59 modifier to the 95900 when billing the 95903 for the same nerves. For example, if the tech tested 4 95900 and 4 95903, she is submitting 4 95900 with a 59 modifier and 4 95903. Since I have been billing on the 95903, the new doctor that I just started billing for is now upset because he is being paid less than the other girl who bills, but she's billing incorrectly. I printed off the CCI, but all it says is a modifier would be needed if billed together. Is there any detailed documentation that I can show this doctor and biller that they are not two differnt procedures?

Thanks for your help.

Julie Tollefson

SuperCoder Answered Tue 04th of January, 2011 18:55:28 PM

Rest assure. You are absolutely right in coding that way. Please refer to:
http://www.supercoder.com/articles/articles-alerts/pmc/increase-pay-up-for-same-day-multiple-nerve-conduction-studies/

Julie Posted Tue 04th of January, 2011 23:00:18 PM

Thank you for that. Good to have something in writting to prove what I am saying.

Any thoughts about the purchasing studies? I'm trying to wrap my head around billing globally if he didn't perform the studies, but he will interpret the studies and pay the testing facilities for the studies.

Thanks
Julie Tollefson

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