Hello everyone,
I need your opinions please. So, I am billing for a family practice physician and I noticed some coding that I felt was inappropriate (from what I have experienced in my billing career thus far). I tried to explain to this provider that it is NOT appropriate to append modifier -25 to any level E/M being billed with a rapid strep (87880) if the only reason/condition for the encounter is for a sore throat/pharyngitis. Also, I proceeded to tell this provider they were billing wayyyy too many 36410, which I proceeded to tell them the code is only intended for difficult blood drawing where the veins are not easily accessible; I recommended they use 36415 for a routine blood draw if that is what is documented.
This provider bluntly told me I did not know what I was talking about and to continue using the same codes !!!!!
Needless to say I am furious and I told them I was not comfortable doing this. My intuition is telling me to notify this provider I will no longer be providing billing services for them.
What do you guys think about this sticky situation ? Am I wrong or right?
I need your opinions please. So, I am billing for a family practice physician and I noticed some coding that I felt was inappropriate (from what I have experienced in my billing career thus far). I tried to explain to this provider that it is NOT appropriate to append modifier -25 to any level E/M being billed with a rapid strep (87880) if the only reason/condition for the encounter is for a sore throat/pharyngitis. Also, I proceeded to tell this provider they were billing wayyyy too many 36410, which I proceeded to tell them the code is only intended for difficult blood drawing where the veins are not easily accessible; I recommended they use 36415 for a routine blood draw if that is what is documented.
This provider bluntly told me I did not know what I was talking about and to continue using the same codes !!!!!
Needless to say I am furious and I told them I was not comfortable doing this. My intuition is telling me to notify this provider I will no longer be providing billing services for them.
What do you guys think about this sticky situation ? Am I wrong or right?
Hard Headed Provider, Messy Situation !!!!
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