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Please Help~Medicaid Modifier 90673

  1. Arrow Please Help~Medicaid Modifier 90673
    Medical Coding Books
    Please help....I have looked everywhere, perhaps I'm just missing it.

    Is there a modifier I can use when giving two seperate injections at different sites to get paid for both injections for a patient that has Medicaid insurance?

  2. #2
    Public Aid does not accept more than one quantity for a CPT code nor does it accept a modifier. In our practice, we bill with the vaccine code and the unlisted code (in this case CPT 90749 - Unlisted Vaccine/toxoid) and add a description of the procedure. eg. one addtional ______vaccine. Hope this helps.

  3. Default
    I should have specified....the injections aren't immunizations, they are therapeautic. What should I do in this case?

  4. Default
    Does your state Medicaid plan have their manual on their website? If so, does it provide a list of acceptable modifiers? I know for Medi-cal (in Calif) modifier 59 is only acceptable on one CPT code. A chart of billable modifiers is provided.

    Good luck!

  5. #5
    Default Injections
    Cristy, are you referencing CPT 96372? I would bill one unit on one line with the diagnosis of one injection and one unit on another line with the 59 modifier and the diagnosis of the other injection.

    Does that help?
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I, AAPC Fellow
    National Advisory Board Member 2018-2021, Region 6 Great Lakes
    Minneapolis AAPC Chapter, Education Officer 2018
    AHIMA ICD-10-CM/PCS Trainer
    AAPC National ICD-10 Trainer

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