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Thread: Preventative visit minus pelvic 52 modifier?

  1. #1

    Wink Preventative visit minus pelvic 52 modifier?

    AAPC: Back to School
    If a lady comes in for a preventative exam and lets say she is 40, provider does not do a pelvic and pap, am I supposed to append a 52 modifier to the 99396?

    Any comments would be helpful.

  2. #2
    Join Date
    Apr 2007


    You don't need the 52 modifier. A pap and pelvic isn't necessary to be able bill a preventive exam for a woman. As long as the visit is a comprehensive preventive visit in the eyes of the provider, it can be billed.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I
    AHIMA Approved ICD-10-CM/PCS Trainer
    AAPC National ICD-10-CM Trainer

  3. #3
    Join Date
    Apr 2007
    Greeley, Colorado


    I agree with Pam. Don't put -52 on the preventive code.
    Lisa Bledsoe, CPC, CPMA

  4. #4
    Join Date
    Apr 2007
    Louisville, KY


    - 52 Modifier is not recognized for use with E/M codes. It seems like this popped up a few years back when I was consulting. Evidently it has not gone away . . .

    E/M, remember, is structured and tiered so that coders have other options if a comprehensive service was not performed. I realize the Preventive Med section is a bit different, but you've heard from the other posts about that part.
    Kevin B. Shields, RHIT, CPCO, CCS, CPC, COC, CCS-P, CPC-P, CPC-I

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