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Thread: blind billing w/venipuncture issues

  1. #1
    Join Date
    Apr 2007
    Everett, WA

    Default blind billing w/venipuncture issues

    AAPC: Back to School
    I've been researching the forum here and cannot find a particular answer to this question so here goes:
    I am billing for an endocrinologist: Right now, I'm blind billing without access to the chart notes unless I specifically ask for each and everyone, but I am not the official coder. The provider bills out the 99214 with the following DX: 401.9, V01.6, 405.1, V58.69. Also to be billed out is 36415 with linked dx 401.9, V58.69, V01.6. Is it appropriate or not to utilize modifier 25 with the office visit? Without the chart notes I can't specifically determine whether or not this is a separately identifiable service just what from is provided here, can I? After all, this is a endocrinology practice. At this point, I'm inclined to NOT append a modifier 25 as a separate and identifiable service, but would like some official guidelines to this scenario or some supportive documentation. Can someone please offer some advice? May need some followup support as well. Thanks so very much...
    ---Suzanne E. Byrum, CPC

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    I would not code without the chart note. I know of no other way to get an accurate bill out the door. Also you do not code a 401.x with a 405.x code on the same claim.

    Debra A. Mitchell, MSPH, CPC-H

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