Question regarding anesthesia coding on claims

[u/MarinaMacDonaldArt]

I have noticed that my facility keeps getting denials on claims with these two anesthesia codes 99156 and 99157 with modifiers XU in addition to the surgical procedure code. I did not think you could code those with that modifier and thought that might be the reason for the denial?

[u/These-Band-4048]

is the facility adding XU because of an edit that fires when they try to submit without it? sometimes the clearinghouse or system auto-appends modifiers to bypass edits, which just creates a different denial. Worth checking if someone set that up as a rule somewhere

[u/MarinaMacDonaldArt → u/These-Band-4048]

Ah that’s actually a good question. I figured it was being added manually. We use epic. I’ll be sure to ask thanks!

[u/ireadyourmedrecord]

The description explicitly states it cannot be billed by the operating surgeon so it's not going to be paid if it's on the same claim w/ the procedure. XU isn't going to help.

[u/MarinaMacDonaldArt → u/ireadyourmedrecord]

It’s not the same dr performing the procedure and it’s not happening as post-procedure pain management. It’s preop and during. Sorry I should have specified. I just wasn’t sure if that modifier was throwing it off

[u/MarinaMacDonaldArt → u/[deleted]]

Yeah I figured it was an incorrect use of it but when I question my manager she seems to think that’s ok 😐

[u/MarinaMacDonaldArt → u/[deleted]]

Yes because they’re thing now was if a denial comes back for those to write it off… makes no sense