Wiki anesthesia add on codes

[LSRamsey]

Is it correct that 99100 is considered a bundled charge under Medicare and should not be billed? Also, you should no longer bill physical status modifiers for Medicare?

 

[aschaeve]

We do not bill 99100 or any physicial modifiers for Medicare.

Alicia, CPC

 

[jdrueppel]

LRamsey,

You are correct. The qualifying circumstances add on codes and physical status modifiers are not payable by Medicare. I have not found the billing of these to be a submission problem EXCEPT with Railroad Medicare where I have experienced electronic claim denials due to the P3/P4/P5 modifiers.

However, keep in mind, if you don't bill the qualifying circumstances and physical status modifiers and the patient's primary insurance changes from Medicare to UHC (for example), you could be losing out on these payable units.

Julie D, CPC