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Wiki RPM Coding CPT code 99454 and 99457 together

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cynthia1126

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There is a question that has arisen and my colleagues and I cannot seem to come to an agreement and everything we look up really is not giving a clear answer. We have a client who is trying to bill 99454 and 99457 on the same patient on the same date of service with a modifier 25. Many of us coders are in disagreement of this for many reasons, however, I am trying to find in black and white the RPM guidelines from CMS that state 99453, 99454, 99457, and 99458 cannot be billed for the same patient on the same day. I found it on another forum, but there was no link to actual guidelines. If someone with experience can give some input, I would be so appreciative. Thank you!!!!
 
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I am having the same issue. It states they can be billed together but some are denying 99457. I did say check with individual payers to see what their guidelines are. They pay the 99453, 99454 but deny 99457 so I wonder if a modifier is required but I can not find anything on this. Any help is appreciated.
 
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