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Thread: July 1st eff. CCI edits for E/M & 96372?

  1. #1

    Unhappy July 1st eff. CCI edits for E/M & 96372?

    AAPC: Back to School
    Does anyone know the correct way to append modifiers for the following codes: 99214, 96372, J1040 & J1100? We have been adding modifier 25 to the E/M code for years and this has been correct, but it has now changed effective 07/01/2010 per Regence (BCBS) with the new CCI edits. Regence is paying on the injection, but denying the E/M as bundled. There is apparently a new way to code these and get paid for both, but I can't find any reference to it anywhere.

  2. #2
    Join Date
    Apr 2007

    Default Just talked to Regence Provider Services...

    I just talked to Regence Provider Services about this because I couldn't find any information regarding a cci edit that would cause the office visit to deny as an integral part of the service. I was told that, at least here in Washington State, that they were having an issue with their system that was just discovered and they are working on fixing the problem.

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