Modifier Question

caseef

Contributor
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11
Location
Overland Park, KS
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I work for a family practice and frequently my docs will see a patient for a physical as well as a ton of other things at the same visit. If I have a patient that has a 99397, 99212, and a 17110, what modifier do I need to use on the 17110? Thanks a bunch for your help.
 

LindaEV

Expert
Local Chapter Officer
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438
Location
Kansas City, MO
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You'll need a 25 on the 99212, but that should be it. That should stop bundling from the OV into the well visit, and the OV into the procedure.
 

caseef

Contributor
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11
Location
Overland Park, KS
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That is what I normally do, then they are denying the removal procedure as incidental to another procedure. I also make sure that all of the diagnosis pointers are correct before I file.
 
Messages
4
Location
Mission Hills, Ca
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We do that as well but make sure there is a different dx linked to the procedure. Many carriers will not pay for a preventative and problem focused visit on same date of service no matter what modifier you use. if anyone has found a way to appeal these I'd appreciate knowing how.
 
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