Several Questions

1. When using 1700 and 17003. We do charge an office visit with modifier 25. Then 1700 by itself. 17003 w/modifier 59, but the units are (lets say) 2. Now the CPT guidelines state to list them separately. I have tried both ways but have not been able to get the 17003 paid.

2. Patient comes to clinic has an ekg, or other tests, performed and was admitted. Now all of sudden! ins is denying the initial admit due to office charges. Does modifier 27 apply to this situation and does it attach to the hospital admit?

3. I am instructed to code as outpatient, pos 22, if pt is admitted for chest pains but the discharge is 21. I am confused on that "direction!" Does it really matter why a pt was admitted to direct what is in/out patient?

Thanks for your response.

Judy

Several Questions