Wiki Office visit w/cerumen removal & Allergy shot...

[shannon.flaherty]

We had a pt. come in the office that we billed ins. for cerumen removal (69210), allergy shot (95115) & an office visit (99213). I was wondering if anyone knew the best way to get paid & if I had to use anything other than a modifier 25?

 

[HBULLOCK]

It depends on the insurance since mh/ntwk/nhp wont pay for both 99213 and 69210..you should only need mod 25 on 99213 line for other carriers to pay for this..hope this helps!!

 

[shannon.flaherty]

Thanks for the help...I'm going to try it w/the mod/25 and see where we get w/that. I'm sure only one is going to pay but worth a try.
Thanks again!

 

[efuhrmann]

please be certain the doc is removing the earwax, using the appropriate tools as defined in the CPT book.