In a recent Insider article, we discussed how some payers are denying claims for evaluation and management (E/M) services submitted on the same day as a procedure or test, even when modifier -25 is correctly used.
Another permutation of this policy is that when an E/M is billed with a procedure code or service that has a global period, some insurers are automatically reducing reimbursement for the lesser-priced service by 50 percent. Allergy skin testing, spirometry, allergy immunotherapy, and injections are considered XXX codes and do not have a global period assigned to them, so this policy should not impact your payment for these services.
However, we recommend that you review such policies carefully and make sure that insurers are not incorrectly applying them to an E/M billed with allergy skin testing or spirometry.
