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Thread: what modifier??

  1. #1

    Default what modifier??

    AAPC: Back to School
    Please help me.
    Provider billed: 99215-25 99396, 90658, 90471-59, 82274, 92551,93000,94010,36415
    except 99215, 90568, 90471, 94010, all other Cpt were for V70.0-routine physical.
    Blue Shield denied 99396 saying included with 94010.
    maybe need to add modifier. what modifer to be added to 99396??
    we have another patient w/identical isuue which were never any problem before Sep.2010
    thank you

  2. #2
    Join Date
    Apr 2007
    Bentonville, Arkansas


    I would think the 99396 needs a modifier -25 also.

  3. #3
    Join Date
    Apr 2007
    Capital Coders, Columbia, SC


    I agree with annielou. Anytime we bill a problem and preventive E/M service together, we append a modifier 25 to both, and they get paid.

    *Helpful tip: I have also advised my physicians that when we report 2 E/M services that we are essentially reporting 2 office visits, and they must be separately documented.

    Bill Hale, CPC

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