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Unbundling ????

  1. Default Unbundling ????
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    Can I use a modifier to unbundle a vision screening when done w/ a preventative O/V, and a sick visit on the same day, because Medicaid is denying for 99173 being bundled with 99385?????

  2. #2
    As long as you are tying the correct preventive visit ICD-9 code to the vision screening CPT, I would think no modifier should be necessary.

    You might want to tell your Medicaid carrier that per CPT 2011, pg. 33, "Vaccine/toxoid products, immunization administrations, ancillary studies involving laboratory, radiology, other procedures, or screenings tests (eg, vision, hearing, developmental) identified with a specific CPT code are reported separately."

    Best o'Luck!

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