DSANDERS1
New
I have a question If I have a 99397 a 99214 and a 17110 where and what modifier do I put on the claim? I put 51 but I think I put it on the wrong Line.
Any help would be great
Any help would be great
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Wiki biller - I have a question
- Thread starter DSANDERS1
- Start date
1formissy
Guru
CPT code 99397 and 99214 are usually bundled when reported on the same patient encounter. If the provider did a significantly separate and identifiable service (documentation support), then you can report the E/M code (99214) with the Preventive Service. (99397).
However, the documentation MUST support service that is completely separate from the preventive service. The E/M code must be a presenting problem, and not that of just a preventive or wellness exam.
Additionally, CPT code 17110 is considered bundled when reported with a wellness exam, and/or a E/M code. Again, if the provider performed a signficiant and separate service, from the lesion destruction, then a modifier 25 would be appended to the E/M.
You should refer to CMS Evaluation and Management Documentation Guidelines, and NCCI guidelines regarding modifier usage.
Hope this helps.
However, the documentation MUST support service that is completely separate from the preventive service. The E/M code must be a presenting problem, and not that of just a preventive or wellness exam.
Additionally, CPT code 17110 is considered bundled when reported with a wellness exam, and/or a E/M code. Again, if the provider performed a signficiant and separate service, from the lesion destruction, then a modifier 25 would be appended to the E/M.
You should refer to CMS Evaluation and Management Documentation Guidelines, and NCCI guidelines regarding modifier usage.
Hope this helps.