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mod.59 for EKG 93000 and ov 99213-25

  1. #1
    Default mod.59 for EKG 93000 and ov 99213-25
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    I'm now questioning myself if I over used mod. 59 for this. I have Medicare paid OV. with mod. 25 and dx: V72.84 but denied EKG 93000 DX: v72.84 as BUNDLED. I reviewed the Medicare LCD and CCI Edit stated a modifier can be added to show the separation. I rebilled to Medicare with mod. 59 on the EKG and Medicare did allowed for it. But now I'm wondering if I over udes the mod. 59 and EKG is bundled with the OV. Please advise. Thank you.

  2. #2
    I use ICD-9 V72.81 for the 93000 in this type of situation (which is covered in the LCDs on Trailblazer's web site) and is reimbursed by Medicare. I would also append modifier 25 with the E/M just as you did.

    Hope this helps!
    Teresa Collins, CPC

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