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#1
06-24-2010, 10:26 AM
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Vaccine codes and Modifier 59
Hello everyone! In need of help ASAP!
99214 - Est. Level 4 90746 - Hep B 90471 - Admin >8 yrs old 90632 - Hep A 90472-59 - Add-on Anthem paid the office visit but not the vaccines and admins. This is how it was originally billed. Now if I'm not mistakened, the add-on code 90472 doesn't need a modifier does it? I need clarification! Thanks! Sarah Mc. 
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#2
06-24-2010, 11:59 AM
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that is correct the first 90472 does not need any modifier.
__________________
Debra A. Mitchell, MSPH, CPC-H 
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#3
06-24-2010, 12:43 PM
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that is correct, 90472 does not warrent the use of any modifiers as it cannot be billed without a primary procedure being billed. The primary procedure for 90472 can be billed with any initial immunization cpt code.
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#4
06-26-2010, 12:35 AM
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All of the payers I've ever billed to do not require any modifiers on the vaccines but do require a mod -25 on the e/m visit.
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