Wiki Palmetto Billing Question

[lmeredith]

We are getting rejection for 99211 has an unbundled relationship with 36415. Is a modifier appropriate?

 

[thomas7331]

A modifier 25 is allowed on 99211 for this code pair. Whether or not it is appropriate will depend on the documentation for the encounter. If the only reason for the visit was for the blood draw, however, then a separate visit charge, 99211, should not have been billed and a modifier would not be supported.

 

[lmeredith]

It was a Telehealth visit in which vitals were done then labs drawn, would the modifier still be appropriate?