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Qualifier for 90772?

  1. Default Qualifier for 90772?
    Medical Coding Books
    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.

  2. #2
    Columbus, Ohio
    Default 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.
    Taryn N. Linstedt, CPC

  3. #3
    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.
    Dawnelle Beall, CPC, CPMA, CPC-I
    Licensed AAPC PMCC Instructor
    AAPC ICD-10CM Certified Trainer
    Previous AAPC Local Chapter President & VP

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