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Modifer 59

  1. Default Modifer 59
    Exam Training Packages
    Good morning,

    I need some input...does anyone know if you can add a modifier to CPT codes 90470 or 90471. These codes were billed out together and the insurance company is denying for "bundling." Thanks!

  2. #2
    Hyattsville Maryland
    I do not see a 90470 in CPT 2010. Is this a DOS during this year? The only CPT I see is 90471 and add-on code 90472.
    Catherine Du Toit CPC, CPMA, CGIC,
    AAPC Professional

  3. #3
    Columbia, MO
    90470 is a code for H1N1 administration that was added September 28 2009 and activated immediately. Some 2010 CPT books had already been printed when this code was activated so it is not in your book but an active code even still. The other part that was left out is that 90470 is for an initial vaccine as is 90471 so you cannot code both together. 90472 adds on to either 90470 or 90471. So you can code 90470 and 90472, or you can have 90471 and 90472, but never 90470 and 90471.

    Debra A. Mitchell, MSPH, CPC-H

  4. Default
    Thank you for your input. I appreciate your help.

    Vonnie P CPC, CPC-H

  5. #5
    Hyattsville Maryland
    Yes, thank you, now I know too. I will add it into my book.
    Catherine Du Toit CPC, CPMA, CGIC,
    AAPC Professional

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