Wiki what modifier??

[southbaymed]

Please help me.
Provider billed: 99215-25 99396, 90658, 90471-59, 82274, 92551,93000,94010,36415
except 99215, 90568, 90471, 94010, all other Cpt were for V70.0-routine physical.
Blue Shield denied 99396 saying included with 94010.
maybe need to add modifier. what modifer to be added to 99396??
we have another patient w/identical isuue which were never any problem before Sep.2010
thank you

 

[annielou]

I would think the 99396 needs a modifier -25 also.

 

[halebill]

I agree with annielou. Anytime we bill a problem and preventive E/M service together, we append a modifier 25 to both, and they get paid.

*Helpful tip: I have also advised my physicians that when we report 2 E/M services that we are essentially reporting 2 office visits, and they must be separately documented.

Bill Hale, CPC