Preventive visit, office visit, and a procedure on same DOS.

pvang

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Hi-

I need clarification and confirmation on this issue. We have a claim that was billed on the same DOS codes:

99396- Preventive visit
99213 with mod 25- E/M visit
11302- Shave skin lesion

We are getting a deny edit on the 99396 as being bundled in to 11302.

My rationale was that modifier 25 will need to also be appended on the 99396 also to make this a distinguish service from procedure 11302. Same concept applied to the 99213 that's why the provider billed it with modifier 25 to eliminate this coding issue.

Am I correct?

Thanks in advance for the help!

Pvang
 

pvang

Networker
Messages
91
Best answers
0
?

I would really like clarification on this if anyone knows anything..that would be great! Thanks!
 
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