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modifier on 99213 with 73110???

  1. Default modifier on 99213 with 73110???
    Medical Coding Books
    This patient has Aetna ins... Our software is asking for a modifier on the office visit and the only other charge is the xray for wrist. Please help... which modifier if any should be used???

  2. #2
    It shouldn't be asking for one. Check to make sure that you've entered the CPT's correctly, and check the patient's history for 90 days prior to the DOS to rule out any global periods. If you're still getting the same answer, I'd submit the claim anyways and fight it if it denies. No modifier should be needed, and one wouldn't be appropriate with just these codes.

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