Billing smoking cessation counseling with E&M and EKG

WEVA99

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My cardiologists have recently started billing the tobacco cessation counseling codes 99406 and 99407. I know when billing these codes with a separate E&M, we need the 25 modifier on the E&M. Sometimes, an EKG 93000 is also done. My question is, do we need a 59 modifier on the EKG when billing all three codes together? I've found one online source that specifically says we do need the 59 in this scenario, but nothing else addressing billing the three services on the same date by the same doctor. Any help with this would be appreciated!
 

Chelle-Lynn

True Blue
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Modesto, CA
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There are no CCI edits for when the 3 codes are billed together indicating that any additional modifiers are required. With that said I know that depending on the carrier some will require the use of the modifier 25 on the E&M to differentiate between the E&M and the 93000 or the 99406. The answer to this may be dependent on the carrier and their internal policies. In these cases I would work with your billing office to monitor which carriers have specific requirements in place.
 

Partha45

Networker
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Chennai Local Chapter
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When submitted 99406/99407 with E&M codes, modifier 25 required for E/M service. You can refer in page#38 in 2019 CPT manual.
Modifier 59 depending on payer can use for CPT 93000
 
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