Forwarding this answer from Dr. Whitten's office, our local CMD, regarding their answer to a question I had on reduction of vascular study payment. This happened when the E&M code was sent in without the modifier 25 when the patient was seen in office and had a vascular study the same day. >From: "Linda Windley" <[log in to unmask]> >To: <[log in to unmask]>, "Diane Seagroves" <[log in to unmask]> >CC: "dick whitten" <[log in to unmask]> >Subject: RE: >Date: Fri, 16 Feb 2001 13:50:35 -0800 > >Diane: >Sorry for the delay in this response, but I have been in training. >You are correct, you will not need a modifier when billing an e/m and >vascular study on the same day. > >The claims that were denied because of no modifier, you need to resubmit >with the modifier. > >Claims where the e/m was paid and the vascular study was reduced, you need >to ask for an appeal. You might try a telephone appeal first. You will need >to tell the rep. that the vascular study was reduced by the allowable for >the e/m. You want to add the 25 modifier to the e/m so they will need to >adjust the vascular study also, and pay it at the full rate. I hope this >makes sense to you. > >Remember the requirement for the modifier is a temporary suspension, HCFA >may bring it back in the future. > >Linda Windley > --- Diane Seagroves RVT Olympic Vascular Lab Olympia, WA --- [log in to unmask] --- EarthLink: It's your Internet.