Wiki Modifiers for 3 lines E/M code, 97140 (manual therapy), and 98926(manual manipulation)

[nic3436]

I have a provider that is billing all 3 lines, her notes are all there and she has performed all the above. What modifer do I use?
I have used 25 on e/m then a 59 on the other 2. Only one of the other 2 will pay. How do I get them all to pay?

 

[trarut]

According to the CCI edits, there are two edits related to your claim lines:

Code 97140 is a column 2 code for 98926. You may not override the edit.​

CCI Edit Rule:​

Standards of medical / surgical practice​

​

Code 99214 is a column 2 code for 98926, but you may use a CCI-associated modifier to override the edit under appropriate circumstances.​

CCI Edit Rule:​

CPT Manual or CMS manual coding instructions​

​

You basically unbundled all three service lines with nothing left for them to be unbundled from.
Assuming 97140 could be reported with a modifier and that the separate E/M service is billable, I would have reported E/M-25, 98926, 97140-59.