• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki modifier 59 oncology

fmshero1

New
Messages
9
Location
Fredericksburg, VA
Best answers
0
a patient has aetna medicare and had a infusion the medicine was billed to pharmacy but the injection was billed to medical, aetna medicare denied for no medication what would be the proper modifier to apply on a corrected claim to aetna medicare for the injection? One thought was a 59 to show separate service any advice would be appreciated.
 
I file medications/vaccines we aren't billing for with a $0 charge (or $.01 charge if your system does not allow $0 charges on claims) along with the injection administration codes. If there is an E&M I append -25 on it with injections (vaccines or medications) but no modifiers on the injections themselves. Ex:

Line 1 - RX CPT $0.00 (or $0.01)
Line 2 - 96372 $25.00
 
Top