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Thread: if 25 does not cover 2 or 3 procudures,what to do?

  1. #1

    Exclamation if 25 does not cover 2 or 3 procudures,what to do?

    AAPC: Back to School
    Please helps us: two issues
    1. He is DO: 99213-25, 98926, J0696 & 96372.....always denied 96372
    as included w/another procedure. BUT not.

    2. Internal medicine: 99213-25, 10016, 90718, 90471, J0696 & 96372....
    again 96372 is denied as included w/another procedure.

    What modifier to append? 59 or 76

    Thank you

  2. Default

    I would do the 59 on the 96372 because the 90471 is for the immunization of the tetanus and the 96372 is for a theraputic injection.

  3. #3
    Join Date
    Apr 2007
    Sioux Falls South Dakota


    In the first case (the DO) 96372 is bundled with the manipulation, 98926. It is, however, allowed with a modifier if applicable.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  4. #4


    When I have more than one procedure in a session I check the CCI to see if they bundle.

    96732 and 98926 bundle need modifier on 96732

    10016 is not a valid code....do you mean 10061

    96372 and 10061 bundle as well....need modifier on 96732

  5. #5


    Thank you for everybody.
    Yes not 10016, 10061.
    Anyway 96372... cann't be alone

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