Forum - Questions & Answers

Oct 7th, 2015 - sabrinagen 5 

Any allergy groups out there? CPT® 95004

Good Morning :)

We are getting denials for 95004 as bundled with pretty much any CPT® code we bill for a few insurances. Wondering if anyone else has experienced this? I can't find any policies, and when I call the insurance companies they can't provide any details on why it's denying this way other than it's what their system shows.
Thanks!

0 Votes - Sign in to vote or reply.
Oct 7th, 2015 - LBAROGIANIS 250 

re: Any allergy groups out there? CPT® 95004

How are you billing it? Per CCI edits, office visits and 95004 are mutually exclusive of each other. They would both need a modifier and I am not sure that will fly.

0 Votes - Sign in to vote or reply.
Oct 7th, 2015 - chriskhans 2 

re: Any allergy groups out there? CPT® 95004

I work for an allergy specialist. I never have issues with 95004 being bundled into any other procedures we do here. Can I ask what other procedures you're billing it with?

0 Votes - Sign in to vote or reply.
Oct 7th, 2015 - sabrinagen 5 

re: Any allergy groups out there? CPT® 95004

Sometimes we bill the OV-25 and the 95004, and other times we may bill the OV-25, 95004 (x units), and 95024 (x units)

0 Votes - Sign in to vote or reply.


About Codapedia & Find-A-Code Contact Us Terms of Use Privacy Policy Advertise with Us

Codapedia™/Find-A-Code™ - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain) - Fax (801) 770-4428

Copyright © 2009-2019 Find A Code, LLC - CPT® copyright American Medical Association