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Thread: Medicare issue

  1. #1

    Default Medicare issue

    AAPC: Back to School
    Is Medicare dening procedure 90772; stating it is not paid searately, for anybody else? If we bill it with an office visit we add the modifier 25 and if two injections are given we add 59 on one of them but Medicare has been kicking them out. Is there a new edit I am not aware of?

  2. #2

    Default Appeal It

    our Office Was Also Having The Same Type Of Problem You Have Run Into. Because Of Our Specialty, Oncology/hematology, There Are Instances Where We Give More Than One Injection On The Same Day, But Different Sight Of Course. Our Second 90772 Billed At Times Will Be Paid, But At Other Times We Have To Appeal With Documentation. We Have Had Luck With Getting Our 2nd 90772 Paid This Way. Oh Yeah, And Don't Forget To Attach The Medicare Appeal Form. Hope This Helps

    Good Luck!

  3. #3


    Thank you! I will appeal. It seems like Medicare causes more work than it's worth sometimes.

  4. #4
    Join Date
    Apr 2007
    Fort Myers, Florida


    Don't forget to check for the new code. 90772 is no longer valid for 2009.

  5. #5

    Wink 90772/96372

    make sure you are billing a quantity of two on the same line, we also add a
    "59" modifier to the now 96372.

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