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Wiki 99396 pe codes with vaccine admistration code 90471- 90460 question modify use

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KimHolt01

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If you are billing out a 99396 with the administration of vaccine 90471 would you append a 25 modify to the PE or would you append a 59 modify to the administration code. After looking at the coding instruction in the 2019 book questioning the use of the 25 Modify on PE with administration of vaccine. The coding book seems to show in the Medicine section that the correct modify for this is 59 on the administration. The PE section shows that 25 should only used when trying to show that another EM code is being billed. Several payers if you apply no modify will pay the administration code and bundle not pay the PE. Question is what is the correct modify with this 25 on the PE or the 59 on the 90471?
 
99396 mod

Code 99396 is a column 2 code for 90471 , but a modifier is allowed in order to differentiate between the services provided.
*Use modifier with code 99396
CCI edit Rule:
CPT Manual or CMS manual coding instructions

The above message per AAPC coder. Great info you should consider subscribing as it is very helpful
 
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