• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Well Child Visit and Mother's Postpartum (96161) together

SKPierce

Guest
Messages
1
Location
Temple, TX
Best answers
0
How to bill for a newborn well child visit (ex: 99391) along with the mothers postpartum (ex: 96161) under the newborn. Does the CPT 96161 need a modifier?
 
99391 and 96161. Yes, you bill both under the baby. No modifier needed
I have a claim that denied the 96161 when we billed it to BCBS commercial insurance with 99391. Reason given was it was a non-covered service because it is a routine/preventative exam or a diagnostic/screening procedure done in conjunction with a routine/preventative exam. My provider is questioning why they are denying. I have searched EVERYWHERE, payor website, policies, guidelines and manuals, LCD & Article Lookup, NCD Lookup and I can not find a policy that states that this is a bundled service. Can anyone provide me with any guidance on this? Thank you in advance for your help.
 
Top