e&m w/prolonged visit and Tx

raynas613

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can you bill a 99203, 99354 and 98942 all in same visit? modifier 25 on E&M only? any other modifiers needed?
 

rthames052006

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Best thing to do is check the NCCI edits to know if these codes can be billed together and if they can be billed together the edits will also tell you if a modifier can override it as well.
 

sophiaz8

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I have not been able to use the 99354 with any other code but the E/M. I had a physician that tried to use it with and E/M 99336,25;99354 and 69210. The code check in our system scrubbed it stating that the 99354 is included in the 69210. It could not differenciate with CPT code it was to apply to.
 

mitchellde

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I have billed these three together many times and always I am paid on all three. As long as your documentation can clearly show that the extra time spent was not for the procedure or test itself you should be fine and if not paid then appeal.
As far as the code check in your system you will need to find out how to over ride it if your documentation supports all three.
 
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