Qualifier for 90772?

styson

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Medicare is saying that in order to unbundle the injection code from an E/M visit on the same day, you need to put a 25 modifier on the E/M code but also a "qualifier" on the 90772.
What is the qualifier that is needed?
I have never heard of this.
 

linstedtt

Contributor
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Columbus, Ohio
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Add 59

Add a modifier 59 to your 90772. This will also work with most insurances, and I know that Medicaid HMO's will pay a few dollars more when you use this in conjunction with your E/M with a 25 on that.
 

valleycoder

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Flower Mound, TX
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Dont forget that modifiers have their own criteria that needs to be met before applying them. i would be leary of using them just to qualify for additional reimbursement.
:)
 
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