Wiki cpt 97530 & 97537

[camedbill]

We have been denied my Medicare that these codes are mutually exclusive. Are there any modifiers that we can use to clear these edits?
Thank you in advance for your help

 

[shruthi]

As per CCI edits 97530 and 97537 cannot be billed together unless an modifier is used.
So we can bill 97937 with 59 modifier.

 

[mitchellde]

Yes you CAN bill with the 59 modifier but SHOULD you is the real issue. It will depend on the visit and the documentation at to whether you can bill both services with a modifier. Never append a modifier just because you can, ALWAYs check the documentation first. So given that what is the documentation for you encounter?