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Question CPT 99497 and correct modifier

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ymajestic04@gmail.com

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Manchester, WA
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Our office usually bills a 99497-33 when doing a G0439 but occasionally a 99497 will come up during a regular outpatient visit. My question is, should I use a different modifier if I am billing it with, for example, a 99214? Thanks for the help.
 
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