AAPC - Back to school
Page 2 of 2 FirstFirst 12
Results 11 to 13 of 13

Thread: What Is Wrong?

  1. #11
    Join Date
    Apr 2007
    San Diego


    AAPC: Back to School

    To add to what "priceor" stated....

    (-59) can also be used on "Medicine" codes....surprisingly enough....I learned that not too long ago while doing some audits. Prior to this, I, too, was under the impression that (-59) was only for "procedures".
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

  2. #12

    Default Billing Coordinator

    We came upon this problem and it was quite frustrating for us. We discovered that some payors make quite a distinction on the way they pay for "physical medicine" codes and the contract for Medical Doctors may be different then for Doctors of Osteopathy. We finally came with an alternative code that seemed to be exempt for all the road blocks and that code is 97140. I would still make use of the modifier "25" if is in addition to another e&m visit if unrelated.

  3. #13
    Join Date
    Apr 2007
    Green Bay, WI


    Quote Originally Posted by willlen View Post
    I am billing Medicare for Doctor of Osteopathy (DO) using 2 codes: E/M code99213 with modifier 25 and code 98926 - osteopathic manipulation. For many years we got payment for both codes. Suddenly, week ago I got payment only for code 98926 and zero for code 99213 wich was bundled with code 98926. What happened? And what can I do?

    Both codes are billable together (providing that documentation supports them). Did you use the correct somatic dysfunction diagnosis for the OMT.
    I code for multiple DO's and they normally have a separate diagnosis for the office visit and the somatic dysfuntion (based on location) for the OMT.

Page 2 of 2 FirstFirst 12

Similar Threads

  1. The answers we got wrong
    By sandya in forum ICD-10
    Replies: 3
    Last Post: 07-03-2015, 07:07 PM
  2. Please let me know what I did wrong...
    By dangill628 in forum Medical Coding General Discussion
    Replies: 9
    Last Post: 03-31-2012, 02:06 PM
  3. wrong modifier
    By boozaarn in forum Billing/Reimbursement
    Replies: 0
    Last Post: 02-06-2011, 07:45 PM
  4. Where did I go wrong?
    By jdibble in forum Anesthesia
    Replies: 10
    Last Post: 12-29-2010, 07:52 AM
  5. Does any one else think it is wrong?
    By mitchellde in forum Medical Coding General Discussion
    Replies: 7
    Last Post: 05-25-2010, 12:18 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.