Wiki need help pls! modifiers

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dorothyann30@yahoo.com

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hi i need help pls ive been having problems with ncci edits especially billing amerigroup insurance , what modifiers to use in billing pediatrics, i really need advice pls on how to bill this one .

99392
94760
90460
90471
90633

what modifiers to use plss in each cpt code ?

99382
90460
90471
90472
90473
90710
90660
90696
82735

what modifiers to use pls in each cpt code pls?
 
I think the problem may be that you are mixing codes. 90460 is the admin of the first antigen of a vaccine with counseling under age 18. 90471 is the admin of a vaccine without counseling any age or admin of any vaccine w/or w/o counseling age 18+

So, in this scenario, you would code
99392-25
94760 (this is a pulse ox, is this correct or do you mean 90647 Hib?)
90460
90633
90460


99382-25
90710 (MMRV, this is a 4 antigen vaccine)
90460
90461 with 3 units
90660
90460
90696 DTaP and IPV, also a 4 antigen vaccine)
90460
90461 with 3 units
82735, my office does not offer fluoride treatments, so not sure about this one.

Watch your antigen counts. You get paid PER antigen with the vaccines, provided you do the counseling. So, MMR, DTap/TDap would be 90460, 90461 x 2 units, Kinrix and Proquad are both 90460, 90461 x 3 units, Pentacel or Pediarix are both 90460, 90461 x 4 units.

Hope this helps!
 
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