Forum - Questions & Answers
CPT® 45380 not payable by Kern Health -Assistance Required
Hello Coding Experts,
Kern Health System in CA does not pay for secondary procedure 45380 billed with modifier 59 along with 45385 (with modifier SG) on the same day. We tried to appeal secondary procedure 45380 along with medical records and with copy of CCI edits however we are not getting reimbursed still stating denied as inclusive. Do other Gastroenterology practice face the same and I would like to get help how this needs to be properly handled so that we get paid for CPT® 45380.
Do we need to follow any other coding guidelines on billing secondary procedure 45380 to Kern Health Sytem.
Kindly advise,
Thanks
Brian