Pam Posted Thu 16th of November, 2017 14:08:08 PM
Patient comes in with Acute bronchitis, unspecified J20.9, Couch R05 and COPD J44.0. We bill an OV 99214-25, Spirometry (Pre & Post) 94060, Nebulizer Inhalation Therapy 94640-51, Depomedrol j1040 and an injection fee 96372. Our clearing house says that
96372 will not be paid with 94060 unless modified and also 94640 will not be paid with 94060 if not modified. Help I'm confused.
SuperCoder Answered Fri 17th of November, 2017 01:17:17 AM
>Yes there are bundling issues, as per NCCI edits, between CPT codes 94060 and 96372. You need to add modifier-59 with CPT code 96372 in order to bill it.
>Now, regarding CPT code 94640 and 94060 bundling issues, c>arriers that follow NCCI guidelines will not allow you to report nebulizer treatment or training in addition to spirometry on the same day. Some private payers may allow you to bill additional services, however. Refer to the following link for further information:
HOPE THIS HELPS!