Compliance Question of the Week

For the Week of April 12, 2021

Cardiology

Cardiology Question for the Week of April 12, 2021

Question:

In the example of the EKG with an EP study, do you agree that we should report the 93005 but not modify it with modifier 59? Do other hospitals override the edit instead of using the GZ? If the entire claim is denied due to the GZ modifier being on the claim, what action should we take? Should we reach out to our FI?

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Laboratory

Laboratory Question for the Week of April 12, 2021

Question:

Can modifier 91 be appended to every laboratory code that is reported more than one time on the same date of service?

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Pharmacy

Pharmacy Question for the Week of April 12, 2021

Question:

Can you tell me more about when to use initial service codes versus additional codes for drug administration services?

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Radiology

Radiology Question for the Week of April 19, 2021

Question:

If a film is obtained to verify the position of the clip placed during a needle localization procedure, can we bill this with the unilateral mammogram code 77065?

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Respiratory

Respiratory Question for the Week of April 12, 2021

Question:

If a nurse is furnishing services that do not require the need for a respiratory therapist would the service be separately billable?

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General

General Question for the Week of April 19, 2021

Question:

I’m being told I need a modifier if I bill 79005 and 78014 together. Do you know which modifier and why?

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