Wiki modifer help Please


Fallbrook, CA
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We have a new computer system. We are running into a problem I haven't had before. A patient comes in for either a physical or AHA (G4038/G0439). If they have other problems we bill a E/M (99213)code also. Then if they have eg: 17000,20600,17110 etc. done I usually bill as follows.
Insurances are saying the 99396/G0439 are bundled. Is there a modifier I can put on the 99396/G0439? I haven't done this in the past. I don't think the 59 would work on the 99396/G0439 also I don't think I can use the 25 twice. Any help appreciated. Thanks

I don't mean to say we bill the 99396,G0439,99213 and 17000. I'm just giving a couple of examples. What I meant is if we billed a 99396,99213,17000. OR a G0439,99213,17000. I don't know if a modifier 25 could be used on both the 99396 and 99213? Thanks
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If you read the descriptions of G0438/G0439 and compare to 99387/99397, you will see they say essentially the same thing, therefore they would be bundled.

As for the other question: if you are billing 99397, 99213 and 17000, the only modifier you would need is -25 on 99213.

The -59 is used to identify a separate procedure and in the above example, there is only one procedure: 17000.