Wiki Denial on Code 96136 with E/M and 90833

[klen]

Hi Coders,

My physician (psychiatrist) is billing CPT codes:
99213-GT
90833-GT and
96136
DX: F900

The provider is receiving denials on 96136 as "mutually exclusive". The remit didn't specify which code 96136 was bumping up against but I'm guessing it's 90833.
Is there a modifier I can use to separate out code 96136 so payers will see this as a separate service?

I don't normally bill for our psychiatry client so I am at a loss.

Thanks for your help!

 

[sls314]

Hi Coders,

My physician (psychiatrist) is billing CPT codes:
99213-GT
90833-GT and
96136
DX: F900

The provider is receiving denials on 96136 as "mutually exclusive". The remit didn't specify which code 96136 was bumping up against but I'm guessing it's 90833.
Is there a modifier I can use to separate out code 96136 so payers will see this as a separate service?

I don't normally bill for our psychiatry client so I am at a loss.

Thanks for your help!

The CCI edit is between 99213 and 96136.

A modifier is allowed to override the relationship, only if the services are unrelated and separately identifiable.

 

[klen]

Thank you for your help, if the modifier guidelines apply, what modifier would you recommend? I'm thinking a -25 modifier on making the coding on this line 99213-25-GT.
I normally bill for surgery so my first thought was to add -59 to 96136 but I don't think that would be appropriate.

Thanks again for your help.