I am starting to recieve denials from an ins co when a patient has the following procedures: 99215/25, 99396, 90658, and 90471. They are paying the 99215/25, 90658 and the 90471 and dening the 99396. They state the 99396 is bundled with the 90471. Does the 90471 require a modifer 59 in order for it to go thru claims check? This has not been a problem in the past it has been occuring more so in the past couple of months.