Wiki J9190 96411 and 96416

[Maryst]

We are billing J9190 with 96411 and 96416. We are now getting denials by medicare replacements stating the 96411 is bundled with 96416. Does anyone know a reason for this?

 

[abc1099]

We are not having any issues. We bill the 96416 with a 59 modifier.

 

[mitchellde]

I think it will depend on your particular scenario as to whether you can or should add the 59 modifier.

 

[abc1099]

That's correct Debra. We have one carrier that doesn't want the modifier but find that WPS Medicare is paying okay on this.