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Re: Billing limits?

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We often bill multiple procedures.  I don't think I've put 6 with a charge on a single invoice, but have definitely put 5 (office visit + 2 vaccines + 2 admin codes) plus the PQRI codes.  If it gets denied, then I'd add either a -24 or -25 modifier.

 

 

or anybody...is there any limit to the number of CPT items we can bill for one patient, on one bill, or one date of service? I had a patient in for health maint. visit, gave a flu shot, drew some blood, and froze a couple of actinic keratoses. So, suddenly, I have 6 items on the bill, and I have this strange feeling that I heard somewhere " they " can deny procedures beyond the 4th. Ever hear anything like that? I spent a few minutes Googling it, but didn't see anything.---Sharlene

-- Pratt

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You used to be limited to 4 ICD-9 codes but it’s unlimited charges. It’s just that insurance often bundles these charges and if you do an E & M with a procedure you need to put a -25 modifier on the E & M code. And more than 1 procedure unrelated requires modeifiers. I use -59 too but I forget what that one is for. Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of PrattSent: Wednesday, January 18, 2012 1:09 PMTo: Subject: Re: Billing limits? We often bill multiple procedures. I don't think I've put 6 with a charge on a single invoice, but have definitely put 5 (office visit + 2 vaccines + 2 admin codes) plus the PQRI codes. If it gets denied, then I'd add either a -24 or -25 modifier. or anybody...is there any limit to the number of CPT items we can bill for one patient, on one bill, or one date of service? I had a patient in for health maint. visit, gave a flu shot, drew some blood, and froze a couple of actinic keratoses. So, suddenly, I have 6 items on the bill, and I have this strange feeling that I heard somewhere " they " can deny procedures beyond the 4th. Ever hear anything like that? I spent a few minutes Googling it, but didn't see anything.---Sharlene-- Pratt

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Thanks, I thought I remembered hearing it sometime. Of course, I will use the

25 modifier on the preventive service code.---Sharlene

>

>

>

> or anybody...is there any limit to the number of CPT items we can bill

> for one patient, on one bill, or one date of service? I had a patient in for

> health maint. visit, gave a flu shot, drew some blood, and froze a couple of

> actinic keratoses. So, suddenly, I have 6 items on the bill, and I have this

> strange feeling that I heard somewhere " they " can deny procedures beyond the

> 4th. Ever hear anything like that? I spent a few minutes Googling it, but

> didn't see anything.---Sharlene

>

>

>

>

> --

> Pratt

>

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