modifer

  1. M

    Wiki Inappropriate Modifier?

    Hello, we've been experiencing some denials from a specific insurance (medi-cal contracted) stating inappropriate modifier as the denial reason. What would be appropriate here? Thank you!
  2. T

    Wiki Multiple 64455 denied by Medicare.

    Hello, I have a claim that we billed out an office visit 99213 25, injection J1030 , and 64455 on 4 lines with different toe modifiers and a two lines had mod 59. All 4 lines are denying for missing procedure modifier. Can any one tell me what I am doing wrong? I have been researching like crazy...
  3. L

    Wiki Column one and two, modifier inquiry

    Recently, our office visit 99213 with modifier 25 was denied saying that 99213 is a column two code included in column one code, 97597. What would be the appropriate modifier for this situation? Also, can anyone direct me on where to find the column one/two list?
    • Linki
    • Thread
    • column 1 column 2 denial modifer
    • Replies: 3
    • Forum: Modifiers
  4. M

    Wiki BILLING 37231 AND 37225 TOGETHER

    Hello, I need help! Hopefully someone can help me here. When billing for 37231 + 37225 is a modifier required? If so, which one.
  5. buskeys

    Wiki Modifier FP

    What situations can you use mod FP in? Guidelines? I am having a hard time finding a straight forward answer.
    • buskeys
    • Thread
    • family planning guidelines gyn modifer obgyn
    • Replies: 0
    • Forum: Modifiers
  6. buskeys

    Wiki 99406!!! This code haunts me

    Please give any advice with 99406! We have so many issues with it. We have established what is and isn't medically necessary (providers are still not fully understanding that). We have had issues with modifier usage on this, time documentation, etc. I don't know why this code haunts me in every...
  7. J

    Wiki Modifiers

    cpt question: 64405 is a nerve block injection occipital. Insurance is rejecting it and asking for modifier. What modifier should be used and where did you find it if you can?
  8. 5

    Wiki post op visits modifier 24

    Hello, I was not able to find any post about post op care so here is my question. I need some help figuring out what we can bill for in the post op care. Most of the surgeries are 90 follow up that we deal with in our billing department. I bill for a group of multi specialty providers with...
    • 574coding
    • Thread
    • global billing global days modifer post op
    • Replies: 0
    • Forum: Anesthesia
  9. J

    Wiki Two E/M Services, Same Day at Same Clinic, But Two Providers? What modifier??

    Hello! So I work for a clinic, where we have a bunch of different providers who do different things, but they are all under E/M codes. So I just ran into something that I have never seen before. I was entering a 99215 encounter for a provider, and I saw that our EMR system automatically put...
    • jessreese
    • Thread
    • e/m evaluation & management modifer
    • Replies: 1
    • Forum: Modifiers
  10. A

    Wiki Texas Work Comp Modifiers for 99080

    Hello - Does anyone know where I can find a list of appropriate modifiers for Texas work comp. We filled out the DWC073 and DWC069 stating the patient could now return to work. We billed our E/M code as well as the 99080 but used modifier 73. SOMR has kicked it back for the procedure code is...
  11. K

    Wiki Help! Nurse practioners and xrays incident to?

    FOR MEDICARE ONLY....WHAT MODIFIER TO WE PUT ON XRAYS DONE IN THE OFFICE WHEN BILLING UNDER A NURSE PRACTIONER, NOT INCIDENT TO? 26 OR TC?? WE HAVE BEEN PUTTING TC ON THE XRAYS WHEN BILLING OUR NURSE PRACTIONERS AS THEMSELVES BUT FOUND SOMETHING THAT SAID IT SHOULD BE 26? I THOUGHT THAT WAS...
  12. N

    Wiki Technical Component for Sleep Studies

    HELP! I'm a newer billing and still learning so much. The sleep center that my doctor always used just closed and he is wanting to start his own. He is looking into getting a HST machine and hiring a sleep tech to manage it right from our office. My question is being a physician office and...
  13. T

    Wiki modifer help Please

    We have a new computer system. We are running into a problem I haven't had before. A patient comes in for either a physical or AHA (G4038/G0439). If they have other problems we bill a E/M (99213)code also. Then if they have eg: 17000,20600,17110 etc. done I usually bill as follows. 99396/G0439...
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