Wiki Modifier with well checks

[aprillee]

We have a few denied well checks claim that are private insurance asking for modifiers. The shot are paid. Here are a few examples.

99392 denied
90670 paid
90460 paid
90633 paid
90460 paid

Is there a modifier that we need for private insurance (blue cross and medical mutual).

 

[Lynda Wetter]

There are new NCCI edits regarding the preventative visit codes and vaccines/administration. Look at the guidelines on page 35 of CPT. Also on page 478. If you meet the qualifications for a 25 modifier on the visit than you can apply it.