Results 1 to 7 of 7

Need help w/billing

  1. Question Need help w/billing
    Medical Coding Books
    When we have an office visit 99214 and used mod 25 and an inhalation treatment 94640 with 1 diagnosis only - is there a better modifier so the inhalation treatment will be paid

  2. Default
    To my knowledge you should report modifier -25 on the E/M but no modifier is reported with the neb treatment. If you administer more than 1 neb treatment you can append modifier -76 to the additional neb treatments. Also bill for your drugs if you can...

  3. #3
    Talking 99214 w/mod 25
    There is no better modifier. 25 is the correct modifier and insurance should pay both charges. :d

  4. Default
    That is correct, attach -25 mod to the 99214 and most insurances should reimburse both charges

  5. #5
    Yes modifier 25 is correct but from my expierence some insurance do not cover this because they say it is still considered experimental.
    Herbie W Lorona Jr., CPC, CPC-H

  6. #6
    I also agree with Herbie I have heard than some are having trouble with certain payors for this code. The modifier should be -25, though, so you are correct.

  7. Default
    You dont need a modifier for just one treatment, but like someone answered earlier, if there is two txments use 76 modifier for BCBS especially. Most other insurance payers like 59 modifier, example Cigna and Aetna. But with BCBS, I know they only pay for a limited amount of 94640 treatments so check out the payer guidelines for this procedure if you are getting denials.

Similar Threads

  1. Replies: 2
    Last Post: 04-24-2015, 04:20 PM
  2. Replies: 0
    Last Post: 08-24-2012, 08:09 PM
  3. CPC owner of Medical billing service offers remote billing
    By dfallows in forum Resume Postings
    Replies: 0
    Last Post: 06-18-2008, 12:11 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.