Question 99497-33 DENIAL

gijones66

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WE ARE BILLING
99214-25 DX: I10, E11.9, Z79.899, N183 (E&M)
G0439 DX: Z00.00
99497-33 DX: Z71.89
96372 DX: E53.8
J3420 DX: E53.8

CPT CODE 99497-33 IS BEING DENIED FOR CO-236 PROCEDURE OR PROCEDURE/MODIFIER COMBINATION IS NOT COMPATIBLE WITH ANOTHER PROCEDURE OR PROCEDURE/MODIFIER COMBINATION PROVIDED ON THE SAME DAY ACCORDING TO NCC.
I TRIED MODIFIER 59 ON CPT CODE 99497 AND IT DENIES AS (4)- PROCEDURE CODE IS IINCONSISTENT WITH MODIFIER.

I WOULD APPRECIATE ANY HELP I CAN GET. THANK YOU, GLENDA
 

jhendrix08

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I know the denial code says it's the procedure/modifier but I feel like it might be an issue with the Dx code used with 99497. Medicare doesn't pay for any type of counseling so I would try to attach the Dx Z00.00 to it instead and still keep the 33 modifier; that is the correct one. Also, when we bill scenarios like this I also add modifier 59 on the 96372.
I hope that helps.
 
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